HomeMy WebLinkAboutMortgage_Moore (4)/a� '�'4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
t\i�; FOR DEDUCTION FROM ASSESSED VALUATION
`� �.. w�� State Fam 43709 (R6l 506)
� Presaibed by Department of Loral Gwemment Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Audito� ot the county whe�e the propedy is located. -
Filing Dates: 1) Real Property: Dunng the 12 months before �une 11 0/ the year the deduction is to be ef[gcti�. O ZOOEi
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduc6on is to be efiective.
See reverse side for adddional instiuc6ons and qualifications. '��� ,� �
. / ..�ocnn� r(117��TY AUDITOR
(owner or contracf buyer - see
Taxing
Assessed value of real property
March 1, current year
Ii no, what is his / her exact share of inlerest?
on
Key number / legal tion / Record number �
�?G �i�ya oo3,�9r-o,��
D O / — T � � a / Page number � �O �
lrJ V 7
MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curcent year owneR ❑ Yes ❑ No
�0 VU
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contrad seller
Address of moRgagee or conVact seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st�eet, city, state, ZIP code)
Does applicant own property in any other If yes, what county? I Whal Taxing DistricY?
county in Indiana? i
Dedudion approved in the amount of:
20 � �
Signature
i�—�,ji;
�
Cow
COUNTY AUDITOR
Is the property in question:
� Real Propaty ❑ Mobile Hmie pC fr1.1
Has lhis dedudion been requested on
property for current yeaR 0 Yes � No
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� oC�.� �
DI'1��'CC �'�........:�.::.......
C8C(� �r� ���/r
....................
We certify under the penalty of perjury that the above ���—'^'
resident of Indiana and owner of the aforementioned �.. _�_.., _..
3ident address a�a iplipnt
loy Ess�x ��A-e� �Qrn►c�-���.
20
i that the applicants was / were
Person authorized by duty executed Power of Attorney
or by IC 6-1.1-12-.07
of authorized person