HomeMy WebLinkAboutMortgage_Whitten.�'..�"• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
x A FOR DEDUCTION FROM ASSESSED VALUATION
r� State form 43709 (RB / 2{17)
�O�y,. =� Prescribed by Depatlment of Local Govemmenl Finance
INSTRUCTIONS: �
To be filed in person or by mail wifh the CountyAuditor o7 fhe county where the property is locafed. � MAR 2 4 2009
Fding Dates: 1) Real Property: Dunng the 72 months belore June il o/the year fhe deduction is fo be eflective.
2) Mobile Homes assessed under IC 6-iJ-7: Aefween January 15 and March 2 of the year the deduc6on is to be eNecfive.
See reverse side Iw additional insWcGons and qualifiwfions. �jr_ ��,.
or mnVaq buyer - see resjrJttigns m revHrse side)
207C� lo � .1l - _ U�'
of real propary as of March 1, curent year Mongage / ConUact i
aineN year � /
whal is his / her exad share of inte2sl?
name on record is difFerenl ihan Nal of applicant,
mortgagee
belav:
Address o1 rtwM1gagce w mnlrati seller (num6er aM sileef, tity, sta(e, aM ZIP code)
Name of assignee w ner or hdder af mortgage
oS� �- 3 - //
Address of assignee (number aM sVe� ty, stafe, end ZIP a
Dces applicant own property in any olher If yea,
counry in Indana?
❑ Yes ❑ No
Deduction approved in the amount of:
20 J_ 20 _ 20 _
AUtlilOf
20
unpaid as of Ma1ch 1,
Is Ihe appGpnt Ihe sole legal or equitade oMne�
❑ Yes ❑ No
If wmed wilh someone other Ihan spouse, indicate with whom.
I I We certify under Ihe penalry of perjury that the above and foregoing intwmation is true
Indiana and oarner of the aforementione� prpp�rty on March 1, 20
uKiesitlen7addr�swt applicant (number and sfreet.
� i�Z�O S. �50 L
� Person aulhonzed by duly ezecuted Po.ver M Ntome
persm (numberaMStreet.afy.sfafe.aMLPco�e)
DisUict7
!le property in ques6on:
Real Property ❑ Mobile Home
Has th's deduCion been requested on property
tw wnant yeaR
❑Yes ❑No
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Date (month, day, yee�