HomeMy WebLinkAboutMortgage_Newcome�e��`',, STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES
�'n'�= FOR DEDUCTION FROM ASSESSED VALUATION o , T p Year
+ State Fwm a3709 (R6 / 5-06)
Presvibed by Depertmen� of Local GwemmeM Finance
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INSTRUCTIONS: �n ��e Maric
To be filed in person or by mail with the CountyAudito� o( the county where the propeRy is located. /i'�a
Filing Dates: 1) Real P�operty: Dunng lhe 12 monihs 6e(ore ,lune 11 of the year the deduction��gg�e�ff��v AUDITOii
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 o e year e deducG'on is to be eflective.
See reverse side for additional instiuctions and qual�cations.
Applicant (owner or con ract 6uyer - see re nctions o rs side) •
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Taxing D' trid Key number / legal description Record number
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Assessed value of real property as of MoAgage ! Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, curtent year ownef? �s ❑ No
/ � ��O
If no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate wilh whom.
If name on record is different than that of applicant, indicate below: Is t property in question:
eal Property ❑ Mobile Hane (IC 61.1-�
me of mortgagee or contrad seller
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Address of moAgagee or conUad seller (number and t2et, city, state, IP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? Whal Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wrrent year? � Yes � No
COUNTY AUDITOR
Deduciion approved in the amounl of:
20 ��- 20 �� 20 �_ 20 20 20 20
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Signature County Auditor Date
�/ We certify under lhe penalry of perjury that the above and foregoing information is true and corred and ihat the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (oyvners full name) Person authorized by duly executed Power of Attomey
����_ or by IC 6-t.t-12-.07
F dent add ss of applipnt /� � Address of aulhorized person
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