HomeMy WebLinkAboutMortgage_Dunn (6)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�+ J State form a3709 (RS / 4-03) � {j � �
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� Ptesaibed Ey Depariment of Lxal Govemment Finance �i �� �� i'-� !
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iNSrRUCrioNS: MAY 2 �i�(jg(�
To be filed in person or by mail with the County Auditor of the county where the property is /ocated�`
Filing Dates: 1) Real PiopeRy: During the 12 montbs be%re May 11 of the year the deduction is t� eNectiv� � /J
2) Mo6ile Homes assessed under IC 6-1J-7: Between January 15 and March 2 of the yearihe deduction fs�to6e�eB�ctive.
- ���SON CGUPdTY AUDITCP, I
See reverse side for additional instructions and qualifications.
or contrect buyer- see 2stric1i9ns on reverse side)
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Key number / legal
Record number ��
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"�Ce. �L/ dki(O V l/ d `f0
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, current year March 1, current year owne(? ❑ Yes ❑ No
If no, what is his / her exad share of interest?
If name on record is different ihan tFiat
of mortgagee or contrad
Address of mortgagee or contrad seller
If owned with someone other than spouse, indicate with whom.
indicate below:
�n�reet, city. state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sbeet, city, state, ZIP code)
Does applicant own property in any
county in indiana?
Deduclion approved in the amount of:
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Signature
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Is the property in question:
O Real Properry ❑ Mobile Home pC Fr7.1-
If yes, what county? I What Taxing Distnct? Has lhis dedudin� �--- -" ted on
^--- ;O No
COUNTY AUDITOF
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County Auditor
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/ We certify under the penalty of perjury lhat the above and foregoing information is true and correct and that ihe applicants was / were
i resident of Indiana and owner of lhe aforementioned properiy on March 1, 20
name)
Person authorized by duiy executed Power of Attomey
or by IC 6-1.1-12-.07
person