HomeMy WebLinkAboutMortgage_Adams (10)�
STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
_�� / State Fwm 43709 (RS / 4-03)
P�escriEeO by Depanment of Local Govemment Finance
Coun Township Year
INSTRUCTIONS: � ��� `±My�� �
To be filed in person or by mail wiih the CountyAuditor of the county where the property is located. r� i�'i �� r�
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Filing Dates: 1) Real Property: During the 12 mon[hs before May 11 0l fhe year the deduction is to be effective.
2) Mobile Homes assessed under fC 6-1.1-7: Between January 15 and March 2 of the year fhe dedaction is (o b�l�e"f$ctive.
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See reverse side for additional instructions and quali�cations. � �
or coy;r�ct 6uyer - see restrictions on
Assessed valu� roperty a
March 1, cunent year
If no, what is his / her exact
Key numbe�pal
�
Y AUDITOR
oOr„ � O ? I a b� O� Page number ��`
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Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, cunent year owner? ❑ Yes ❑ No
V �+ v
interest? If owned with someone other than spouse, indicate with whom.
If name on record is difiereM than that of applicant, indicate below:
> of mortgagee o contract seller
�• _
Address of mortgagee or contrect seller (number and street, , state, :
Name of assignee or other owner or holder of mortgage
assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing District?
county in Indiana?
20
amount
20 O J%
�
s the property
❑ Real Property ❑ Mobile Home (IC E1.1-7)
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Has this deduction been requesied on
property for curcent year? 0 YesCl No
COUNTY AUDITOR
20 �(� 20 �� 20 - D 9 20 0 20
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County Auditor Date
certify under the penalty of perjury that the above and foregoing infortnation is true and conect and that the applicants was ! were
IRnt of Indiana and owner of the aforementioned property on March 1, 20
name)
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Person authorized by duly executed Power
or by IC 6-1.1-72-.07
of authorized person
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