HomeMy WebLinkAboutMortgage_McAteee`� R�� t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i4�" : FOR DEDUCTION FROM ASSESSED VALUATION P
Coun Townshi Year
�, y State Form 43709 (R4 / 1407J
�� � Prescribed Dy Departmenl ol Local Govemment Finance
INSTRUCTIONS: � IlFil Mar� �
To 6e �led in erson or b mail with the Count Auditor ol fhe count whe2 the ro e �� ��
P Y Y y p p rty is located.
Filing Dates: 7) Real Property: Dunng the 12 months belore May 11 0l the year the deduction is to be eHective.�N 1.I ����
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of the year the d ttio5i rs t Hecfive.
See reverse side /or addifional instructions and qualifications.
,iam, c�nNr aii�
Applicant (owner or contract buyer - see restrictions on reverse side)
Taxing Distrid Key number / legal description Record number
oa
� Q Q ^ O �^�� Page number q�
\
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owne(? ❑ Yes ❑ No
���
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 different than that of applicant, indicate below: is the property in question:
❑ Real Properiy p Mobile Home pC 61.1-�
��ne of moRgagee or conlrad seller
Address of mortga ee or contract seller ( ber and street, city, state, ZIP
Name of assignee or other owner or hoider of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Districl? Has this deduction been requested on
county in Indiana? property for wrrent year?� Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
y
zoQ�`- V zo.Q_ zoo 2oQ� zo r� zo zo�� �
PrAe�ft- � � p
Sig ature County Auditor Dafe
We certify under the penalty of perjury lhal the above and foregoing information is true and corred and that the applicants was / were
.sident of Indiana and owner of the aforementioned property on March 1, 20
SignaWre wners full name) � � Person authorized by duly executed Power of Atlomey
C or by IC 6-1.1-12-.07
Fuil resident address of appliqnt y7 ¢1 C� Address of authorized person
�P/eI� ,(30-� 37� �