HomeMy WebLinkAboutMortgage_Meuser°��"��° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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1\i,�= FOR DEDUCTION FROM ASSESSED VALUATION Count T i Year
`�i+ State Portn 43709 (R6l S-06) - .
� Presvibed by DepaNnent of Lonl Gwemmeni Finance �
NOV 2 2007
INSTRUCTIONS: File Mark
To be filed in pe�son or by mail with the County Auditor of the county where the p�operty is located. `�j� �
Filing Dates: 1) Real Property: Dunng the 72 months before �une I7 of the year the deduction is to be eHectlGe.` °� �
2) Mobile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 o(the ye���(Q�pYTi� Ai,V4��ctive.
See reverse side for additional instniclions and qualifications.
(ownei or contract 6uyer
Taxin( Dislrid
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Assessed value of real property as of
March 1, current year
If no, what is his / her exact share
on reverse side)
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wmber / legal description
�?.G-�d-33-300-00�.
/O 9 -od�
Mortgage / Contract indebtedness unpai�
March 1, current year
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Record number � p 7
Page number � � ��
as of Is the applicant the sole legal or equitable
ownef? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
If name on record is different than Ihai ot applicant, indicate below:
�me of mort ee or contred seller _
Address of mortg ee or contrad seller (number and stieet, city, state, :
Name ot assignee or other owner or holder of mortgage
(number and st2et, city, state, ZIP code)
Does appliwnt own property in any other If yes, what county? I V�
county in Indiana?
Deduction approved in the amount of:
zo 0 zo b zo
P P
Signature
COUNTY AI
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County Audilor
s the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
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Dale
d on
� No
We certify under the penalty of peryury that the above and foregoing informalion is true and corred and that the applicants was / were
resident of Indiapa and owneryf the aforementioned property on March 1, 20
/ull
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
s orappucant � Address of authorized person
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