HomeMy WebLinkAboutMortgage_Garrettii� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
'i' FOR DEDUCTION FROM ASSESSED VALUATION � Count Township Year
w. 1 State Fartn 43709 (R6 / 5-06) �
� Presaibed by Depanment ol Lotal Gwemment Finance
wsraucr�oNS: OCT 0 4 2007F;ie Ma�
To be filed in person or by mail with the County Auditor of fhe county where the p�operty is loca
Filing Dates: 1) Real Property: During the 12 months belore �une I7 of the year the deduction is o e�{
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Marc�6�(�� ���,�ar��'�OR is to be eflective.
See reverse side /or additional instructions and qualifrcations.
Applicant (owneror conhact 6uyer- see rest�dions on verse side)
Ta�cing istrid Key number / legal description' Record number �
I ��-Yttt, alp-ll-Oq-30o'adO�.i71'�a7 Pagenumber ����
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrreiri year March 1, cunent year owneR ��1'es ❑ No
._��y0� �
H no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
I Property ❑ Mobile Home pC 61.1-�
e of mortgagee or conVad seller �
Address of mortgagee or conVad selier (number and st2et, c ty, state, ZIP
Name of aseignee or other owner or holder of mortgage
Address of assignee (num6er and street, ciry, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distric[? Has this deduclion been requested on
county in Indiana? property for current year?� Yes� No
COUNTY AUDITOR
Deduction approved in the amount of:
20 Q� 20 _� 20 20 20 20 20
� P
Signature County Auditor Date
We certify under the penalty of perjury that the above and foregoing information is lrue and corred and thal lhe applicants was / were
esident of Indiana and owner of the aforementioned property on March 1, 20
Si na e(ow rs full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
t resident ad ress o applipnt � Address of authorized person
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