HomeMy WebLinkAboutMortgage_Patterson„.s�:,�a STATEMENT OF MORTGAGE OR CONTRACT
a���° �` INDEBTEDNESS FOR DEDUCTION FRdM ASSESSED
•:�' VALUATION State Form 43709 (1-90) Prescribed by the
����• State Board of Tax Commissioners
Instructions for filing:
To be filed in person or by mail wiih the County Auditor of the county where the
property is located during the 12 months before May 11 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
Filin fee $1.00
i Township Year
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FEB 1 91993 � � �
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Applicant (Owner or contr t buyer - see r strict n o r ver ) -
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District Key Number/Legal scription Record No. /J�
7
• — S Q ' Page No. p
Assessed value of real pr perty as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current year. equitable owner? O yes O no
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
Name of mortgagee or contr er
�
Address of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduction treen
in any other county in Indiane? requested on property for current
year? ❑ yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19�%y 19 � 19 "� 19 19�� 1�6Qp��yr�J �—�
,� s �-a°" 61 - fl- � �
Signature � oaS�cretary�� d�R�e�ew �e � � q�
6 - 3a -98 3- � � � ��o�e -� � � �° P
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�" !s was/were a resident of Indiana and owner of the aforementioned property on March t, 19
, ture (owner full m Person authorized by duly executed Power of Attorney or
by IC 6-1.1-12-.07).
ull Res ent Address of Ap4�can�. Address of Authorized Person
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