HomeMy WebLinkAboutMortgage_Barboura� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Yeai
�--- � FOR DEDUCTION FROM ASSESSED VALUATION
l � � S�ate Fofm 43709 (R41 70.01) _ � - '
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PrescriDeO by DeOarlment ol Local Govemment Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail with fhe County Auditor of the county where the property is located. �-�' .. � ����
Filing Dafes: 1) Real PropeRy: Dunng the 12 months 6e/ore May 11 0l tbe year fhe deduction is fo�be effective. +�j ��
2) Mobile Nomes assessed unde� IC 6-1.1-7: BeAveen January 15 and March 31 of the year the deduchon'is;to be eflective
See reverse side lor additional instructions and qualificafions. �"' � 1- 2�03
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Appiicant (owner or contract buyer- see restrictions on reverse side)
J �. �d. fa-1, �. �rbod�
Taxing Distrid Key number / legal desaiption
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Record number
C� 3- � 33Z
Page number
Assessed value oi real property as of Morlgage 1 Contract indebtedness unpaid as of Is the applicant fhe sole legal or equita
March 1, current year March 1, wrtent year owne(? �Yes ❑ No
� � 6 g or1n� oa
If no, what is his / her exact share ot inleresl? If owned with someone other than spouse, indicate with whom.
name on record is different than that of applicanl, indicate below:
of moAgagee or contrad seiler
Address of
�
3ee or wntrad se
or other owner or
(number and street, city, state, ZIP
of mortgage
Address of assignee (numberand street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid?
county in Indiana?
COUNTY AUDITOR
)eduction approved in the amounl of:
20 20 0�' _ 20 � 20 �_ 20
� p
� anature _ County Auditor
s the property
p Real Property ❑ Mobile Home pC 61.
�g �
Has this dedudion been requested o
property for current year? � Yes � 1
20
Date
20
I/ We certify under the penalry of perjury that the above and foregoing infortnation is true and corred and that lhe applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
�,/�I resideni address of appliwnt
\ IC. �. �� kJDi� � �07 l�►�i rY.e.rt'CYl
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Person authorized by duly executed Power ot attorney
or by IC 6-1.1-12-.07
of authorized person