HomeMy WebLinkAboutMortgage_Morris (6)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
°+ �w� ! Stata Fortn a3709 (RS / a-03) .
� PtesuiOeA by Department ot Lorai Guvemment Finarice
To beR� �TION rson or 6y mail with the County Auditor of the county where the property is lo ted.� ��I�
Filing Dates: 1) Real Property: During the 12 months belo2 May 11 0/ the year the deduction is to be eflective.�.n�1
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 oI theg�th� �em,u�on is to 6e elfective.
aee reverse s�oe ror aaartana� mstnicuons and quaimcanons.
Applicant er or contracf 6uyer - s restrictions on reverse side) GIBS
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Taxing Di rid Key number / legal description Record number '/
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/� � �/ � Ci O (�— b �3 �4 d D Page number �i 7 � /
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Assessed value of real property a of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrtent year March 1, current year owne(? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.1-�
e of mortgagee ntreU seller /j /,��
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Address of mortgagee or contract selier (number and st et, city, state, ZIP
Name of assignee or other owner or holder 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 Disirict? Has this dedudion been requested on
county in Indiana? propeAy for cunent yea(?� Yes❑ No
COUNTY AUDITOR
Deduction approved in lhe amounf of:
20 �( _ 20 20 � 20 ___Q_� 20 20 20
P � P "
Signature County Auditor � Dale :
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
sideni of Indiana and owner of the aforementioned property on March 1, 20
Signa r(owners ( 1 name) Person authorized by duly executed Power of Attomey
�� or by IC 6-1.1-12-.07
ull resident add ess of applicant Address of authorized person
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