HomeMy WebLinkAboutMortgage_Harris•T.,• STATEMENT OF MORTGAGE OR CONTRACT Filin fee $1.00
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ar �=a ` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
-� `� Count Township Year
�� '' VALUATION State Form 43709 (1-90) Prescribed by the
�,�,• '' State Board of Tax Commissioners Q�
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Instructions for filing: $EP 2 �i�,(�lark �
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To be filed in person or by maii with the County Auditor of the county v��here th�� � `
property is located during the 12 months before May 11 of ;he year the deduction
is to be effective. See reverse for additional instructions and qualifications. AV��TOf;
Applicant (Owner or ontract yer - see restricti ns on_reverse) •
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Ta�ing,Di ct � Ke��mbgr/9eOg�l Description Record No.
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\J �-�-I a•�S�C. PageNo. J�(�p
Assessed value of reai property as Mortgage/Contract Indebtedness unpaid Is the applicant the s legal or
of Marcii 1, current year as of M rch 1, current year. equitable owner? es ❑ no
1�3�-�o3a 0
If no, what is hislher exact share or interest? If owned with someone other than spouse,
indicate with whom. - �
If name on record is different than that of applicant, indicate below:
��e of mortgagee or contract seller
�
Address of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduciion been
in any other county in Indiana? requested on property for current
year? ❑ yes rJ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19 9� 19��0 19_��'0� 19��'�• b� ��%b'� �e�,e i'�' �-3 �$ po
51�'10 6�a-a�
Signature Secretary of Bo rd of Review Dat ��9
G- z 9- 1 s ,C3. �--� . ���'� °2`�. C� O� � P
IlWe certify under penalty of perjury that the above and foregoing information is true and correct and ihat the appli-
s was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
Signa r(o rs f II ameD�� Person authorized by duiy executed Power of Attorney or
by IC 6-1.1-12-.07).
Ful Re i ent dress of Aplicant Address of Authorized Person
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