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HomeMy WebLinkAboutMortgage_Wisnoski�;.^'"o STATEMENT OF MORTGAGE OR CONTRACT a�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 H�here 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. Applicant (O�ui ��� Taxing District r- see restrictions on reverse) O-SKI Key Number/Legal Description fee $1.00 I� �.A�° � i �� � I . �i '`� — .� Y_ . _ — File Mark F c�3 "� � 1999 �' F r � `--+'� f' • � : r�, �^ C,R"� Record No. Gc1di I ��7-��7�%—!�d IPageNo. A ss essed value of real propert�as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or of March 1, current year as of March 1, current year. equitable owner? � yes ❑ no /� S' e-�—z) If no, what is hislher exact share or interest? If owned with someone other than spouse, indicate with whom. If name on record is different than that of applicant, indicate below: of mortgagee or contract seller �c�ss Address ef mortgagee or contract seller Name of Assiclnee or other owner or of Assignee of Mortgage. � ; i. /��2 T� c- -���ra 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? O yes O no COUNTY BOARD OF REVIEW ACTION Deduction approved in the amount of: i Signature o�D46 0 19 1,tN/ ( � 1 ,a oo� -� �' / / q,uil ���5-�-� I �7l1/)U!1 Secretary of Board of Review Zoo9-P 19 Date ���, IlWe certify under penalty of perjury that the above and foregoing information is true and correct and that the appli- ts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 nature (owner full name) Person authorized by duly executed Power ot Attorney or �/ , � _ / by IC 6-1.1-12-.07). I Resident Address of Aplicant I Address of Authorized Person iZ ft � Ro,� �z4c_