HomeMy WebLinkAboutMortgage_Halwes`O R� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
- ' FOR DEDUCTION FROM ASSESSED VALUATION
�. � � � SUte Fortn a3709 (R4l 70.07) � . � . - .
�I�u
Prescribed Dy DeDanmenl of Local Govemment Finance
Year
INSTRUCTfONS: _�� � LF.ileMark/ � J"
To be filed in person or by mail with the County Auditor of tbe county where the property is located. '"� 1 y 2003
Fifing Dates: 1) Real Property: During the 12 months before May 11 0l the year fhe deduction is to 6e elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Belween January 15 and March 31 0/ the y/ear the deducfion is to be eflective.
See reverse side for additional instrucBons and qualifica6ons. I/ �_,� n
;a��✓-,!Jt-r�•
. _ , ^.�• - - . _ ... ,..-. .
(owner or contract buyer - see
� . . .
Assessed value of real property as of
March 1, wrrenl year
I( no, what is his / her exact share
name on record is different than thal
tions on reverse side)
-o" S. 4�a,1 wes
Key number / legal desaiplion
006-oo(oy0—o0
Record number
03- (�1
Page number �
MoRgage / ContraC indebtedness unpaid as of I Is the applicant
March 1, curtent year owneR I
� �6 z, 000. o 0
indicate below:
� legal or equitabl�
❑ No
If owned with someone other than spouse, mdicate wrth whom.
''art�e of moA,^ � n gagee or contrad seller
li �n�.i�Ki�� �ou�.u- u• A • � �
Address of mo gagee or conlracl seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand strtet, city, state, ZIP crode)
Does applicanl own property in any other If yes, what county?
county in Indiana?
Deduction approved
r� i '
amount of:
20 �
�
; the property i
❑ Real Property
� � Q
❑ Mobile Hane (IC G1.1 ;
-3�$�
o-og-185o
4Vhat Taxing District? Has this dedudion been requested on
property for wrrent year? � Yes❑ Nc
COUNTY AUDITOR
20 �( _ 20 �
� �
County Auditor
20 D� I2� � I2U
�
I/ We certify under the penalry of peryury.lhat the above and toregoing information is true and wrred and thal the appiicants was / were
a resident of Indiana and owner of the aforementioned propeRy on March 1, 20
(ull
R�R i� eoy�t�� w�;n�-+�, ��, ��r��
Person aulhonzetl by duiy executea rower oi N�comey
or by IC 6-1.1-12-.07 �
of authorized person