HomeMy WebLinkAboutMortgage_Graham (2)� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' = FOR DEDUCTION FROM ASSESSED VALUATION Coun T shi Year
°� �,y. ! Siale Form 43709 (R615-06)
� Resaibed by Department of Lotal Gwemment Fnance
� � " 9 2007
INSTRUCrIONS: � File Mark
To be filed in person or by mail with fhe County Auditor of the county where the property is /ocated. �� �
Filing Dates: iJ Real Property: During the 12 months 6efore ,lune Il of fhe year the deduction is to be s6�Q,
2) Mobile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 of the year the de�fi�il161f9 tR B��ORctive.
See reverse side fo� adddional instructions and qualifications.
Applicant (owner or see restrictions on reve side)
Taxing District Key number / egal description Record number O�
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Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applica t the sole legal or equitable
March 1, current year March 1, curtent year owner? �Yes � No
y� Oa �
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diHerent than that of applicank indicate below: Is the property in question:
� eal Property � Mobile Home QC 61.1-7)
N�e of mort
Name oi assignee or other owner or holder of mortgage
Address oi assignee (numbe� and sbeet, city, state, ZIP code)
Does applican[ own property in any other IT yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for curcent year? ❑ YesO No
COUNTY AUDITOR
Deduction approved in the amount of:
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Signature County Auditor Date
I/ We certify under the penalty of perjury that the above and foregoing infortnation is true and cortect and that the applicants was / were
-ident of Indiana and owner of the aforementioned property on March 1, 20
, t (owner's full name � Person authorized by duly executed Power of Attomey
or by IC 6-t.t-12-.07
Full resident address of applicant Address of authorized person
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