HomeMy WebLinkAboutMortgage_Morrison (5)�rt•n° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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c+ : FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
S��y SUte Form 43709 (R4l 10-01) � O.
a.
� Prescribetl by Depanment of Local Govemment Finance �
INSTRUCTIONS: � � � �M�
To be filed in person or by mail witb fhe County Auditor o! the county whe2 the property is locat ��
Filing Dates: 1) Real Prope�ty: During the 12 months belore May 11 0l the year the deduction is to be ef(ectiv
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 of the ye�ge ��ercZ{i�� to be eBective.
See reverse side lor additional instructions and quali�cations.
(owne� or contracybiykr - see
Key
Record numtler Q �
c
. �\ (�\ � , �� �3g �U Page number � C�
. �� � J
Assessed value of real property as of MoAgage / Contract indebtedness unpaid as of Is the applicant tlie sole legal or equitable
March 1, current year March 1, rrent year �^_' /,� owneR ❑ Yes ❑ No
. . � ��-%. V � � �
If no, what is his / her exacl share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than lhat of applicant, indicate below: Is the property in question:
of mortgagee or contreIX seller
r
Address of mortgagee or contrad seller
assignee or other owner or holder of mortgage
Address of assignee (numberand st�eef, city, state, ZIP code)
Does applicant own property in any other �f yes, what county? What Taxing District?
county in Indiana?
�. COUNTY AUDITOR
leduction approved in the amount of:
�
20� � 20
Q� D �5 � p,�,��
20 0�% I 201� 5
- • �.•
County Auditor
❑ Real Property ❑ Mobile Home QC fr1.1-�
Has this deduction been requested on
property for current year? �] Yes ❑ No
200(c 20 O
� P
Date
� / ! �
certify under the penalty of perjury lhal ihe above and foregoing information is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
r�a (owners full name)
i�n/j ddress� of aPPlican�
Il�_ /l / 7 %�t�_ n
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person