HomeMy WebLinkAboutMortgage_Geuss`° �'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`"�-" '� FOR DEDUCTION FROM ASSESSED VALUATION
S y State form 43709 (R4 / 10.07)
�Prescribed by Department of Laal Govemmem Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor ol the county whe2 the property is located. �^ p� n
Filing Dates: i) Real Property: During fhe 12 months be(oie May 11 of the year the deduction is to be elfecfive. 2 20�2
2) Mo6ile Homes assessed under IC 6-1.1-7: 8ehveen January 15 and March 31 of tfie year the deducfion is to be ef/ective.
See reverse side /or additional instructions and quali�cations.
G'3SQ;; C�.� °.-Y p�JD� � Q3
Applicant (owneror ntract 6uyer- see restriction on revers ide)
Taxing isirid Key number / legal descriptio Record number D
��'��tl `KJ�� ��YJ^ 4 �O�I �Ov Pagenumber /J� ! /
Y�
Assessed value of real property as of Mortgage ! Contracl indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year ownef? ❑ Yes ❑ No
� �
Ii no, what is his / her exact 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:
� Real Property ❑ Mobile Hane QC fr1.1-�
�� of moAgagee or contrect seller
Address of moRgagee or contrad seller (number nd st2et, cify, st , 1-�
Name of assignee or other owner or hoider of mortgage
Address of assignee (numberand street, city, state, ZIP code)
Does appliwnt own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
county in indiana? property for current year?� Yes� No
COUNTY AUDITOR
Deduction approved in the amounl of:
i
20 �6. 20 2a �� 20 0� 20 )` 20 � P 2o D Y 0 9
5 � � � jo P
Sign ture County Auditor Date
�Ne rtiy under lhe penalty of perjury thal lhe above and foregoing information is true and corred and thal ihe applicants was / were
s' enl of Indiana and owner of the aforementioned property on March 1, 20
ig re o er's full na ) Person authorized by duly execuled Power of Attorney
`.
or by IC 6-1.1-12-.07
ul ident address of pli t Address of authorized person
3�