HomeMy WebLinkAboutMortgage_McDaniel;<•=�:,�a STATEMENT OF MORTGAGE OR CONTRACT
-^�\ INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
o'� '��•� VALUATION State Form 43709 (1 90) Prescribed by the
r���'� State Board of Tax Commissioners "
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Insiructions for filing:
To be filed in person or by mail with the County Auditor of the county where the
property is located during the 12 months before May 1 1 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
Filin fee $1.00
County Township Year
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IJAN — 6 1994��
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Applicant (Owner or contract buye - see res rictio on rever e) •
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Taxing Districi Key Number/Legal Description Record No.
�(Q.Y�/If� ���0 ' ��7�9 �li Page No. .S 0
Assessed value of reai property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current year. equitable owner? O yes O no
If no. what is hislher exact share or interest? If owned with someone oiher than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
Name oi mortgagee or contract seller
A ess of mortgagee or contract seller , '
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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 deduction been
in any other county in Indiana? requested on property for current
year? O yes J no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19�95 19�oa 19 19�_p62 �J (� 1�J--_Q,� t9-a.00�
/7 5 `'�b_01 �"�6- 02 P%"R06�
Signat �e �� Secretary of Board of Review Date
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I/We certify under penalty of perjury that the above and foregoing information is true and correci and that the appli-
ca was/were a resident of Indiana and owner of the a(oremeniioned properiy on March 1. 19
Si �ne (ull �e� Person authorized by duly execuled Power of Attorney or
� �' by IC 6-1.1-12-.07).
F I Resident Address of Apli nt P;ddress of Authorized Person
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