HomeMy WebLinkAboutMortgage_Tenbarge (10),<�*°•,. STATEMENT OF MORTGAGE OR CONTRACT
a� _`- INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
.�. ��
=� �' � VALUATION State Form 43709 (1-90) Prescribed by the
�� State Board of Tax Commissioners
�
Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the
property is located during the 12 months before May 11 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
Appiicant (Owner
�
r-$ee�
o�_
� Key
)
Description
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Filinq fee $1.00
County Township Year
!( `
%
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� (�9AY � 01994
\ U'.w,�.e� ,(f . %�t�,�c�-s
ei �nITl1R 0
Record
No. v O
3
Assessed v�lue of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1,��r�t year�[� equitable owner? O yes ❑ no
l�
If no, what is his/her exact share or interest? If wned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contract
Address of mortgagee or contract
of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? ❑ yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19�}'�S I19
Signature
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O/ �s�2 �,61 �o�-a3�P�, ?�60�
� -2,S-o2 J�'
retary of Bo rd of Review Date o 8 btf OS a%
�F � 1 � � � zi
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
�y��ature ( ners fuil name) Person authorized by duly executed Power of Atiorney or
���jJ � by IC 6-1.1-12-.07).
of Aplicant ,, � Address of Authorized Person