HomeMy WebLinkAboutMortgage_Phelps.•�•�a STATEMENT OF MORTGAGE OR CONTRACT
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?��`° �` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
•� ' VALUATIO�! State Form 43709 (1-90) Prescribed by the
`� � State Board of Tax Commissioners
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Instructions for filing:
To be fil-sd in person or by mail with the County Auditor of the county.where the
property is located during the 12 months before May i 1 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications.
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Applica Own r or ontrac buyer - s r trictions n reverse) �
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Taxin Key Number/Le Description Recor o.
[./v�o -U/��� - � Page No. 1p99S
As ssed value of real property as .Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
o arch 1, current year as o Mar h 1, current year. equitable owner? O yes O no
�y ��c��
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:
��e of mortgagee or contract seller „/ /J
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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 Taxin� District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19� 19�-'�6 19 d�� 19_a. bQ� '��b��/1S,(,% 1�9—� �J 00
l "�'�B� b� ' a- b?J P1'iil�o,6
Signature Se�crPta� of Board of Review __Date 09
�-- 3 0� 9£� ,8. e�--�-'' � 2o a �� aoo � l
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 1, 19
Si n ture (owners full name) Person authorized by duly executed Power of Attorney or
� 4 by IC 6-1.1-12-.07).
ull Resident Address of Aplicant Address of Authorized Person