HomeMy WebLinkAboutMortgage_Lloyd (3)e�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'*-'^ s FOR DEDUCTION FROM ASSESSED VALUATION Counry{ Tow ip Year
� S�ale Fotm 43709 (R4 /10-07) � �
�a.
Prescribed by Department of Lorai Govemment Finance
iNSrRUCnonrs: MAY Q ���Mark
To be filed in person or 6y mail with the County Auditor o/ the county where the property is loca tl.
Filing Dates: 1) Real PropeRy: During the 12 months belore May 11 of the year the deduction i o be e
2) Mobile Homes assessed under IC 61.1-7: Belween January 15 and March 31 G� � �urtiC)Bi�4Y'- o eNective.
See reverse side loradditional instiuctrons and qualificafions.
or contracf buyer - see
`-�/L�. �lJ�;
value oi real pro�pe s oarty
March i, wrrent year
on reverse
Key
March 1, current
If no, what is his / her exad share of interesl? ''
If name on record is different than thal of applicanl, indicate below:
mortgagee or contract seller
Address of mortgagee or contrad selier (number and street,
Name of assignee or
Address of assignee
or holder of mo gage
'stieet, city, state, ZlPcode)
Does applicant own property in any
county in Indiana?
Deduction approved in the amounl of:
20
20
�1
Record number
Page number
indebtedness unpaid as of I Is the applicant the sole legal or equitable
r owne(? ❑ Yes ❑ No
with someone other lhan spouse, indicate with whom.
If yes, what counry? � What Taxing District?
r� :
COUNTY AUDITOR
County Auditor
206(�
�
Is the
Real Property ❑ Mobile Hpme pC 61.
Has this deduction been requested on
property for wrrent yea(? � Yes ❑ No
20
Date
20 Q� =
� P
certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
lenl of Indiana and owner of the aforementioned property on March 1, 20
full name)
�.�
Person authorized by
or by IC 6-1.1-12-.07
ress of authorized person
oi