HomeMy WebLinkAboutMortgage_Sporei�� 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION ship Year
S-,w� J Slate Form 43709 (R6 / 5-06)
� Presoibed by Depariment of Loml Govemment Finance
� JAN 2 5 2008
INSTRUCTIONS: File Mark
To be filed in person or by mail with the County Auditor of the county where the property is locafed. �
Filing Dates: 1J Real P�operty: During the 12 months before ,lune Il of the year the deduction is to be�ac 'f�s. �
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and'March 2 0/�1@�9YQ0(M08Nc9A1p(�Rd?be elfective.
See reverse side fo� additional instrucL'ons and qualfications.
Taxing
U/Cl��/ai—/lo�/U/ —
Assessed value of real property as of
March 1, current year
If no, what is his / her exad
Cll
number / legal
�• ic�a -v�
Mortgage / Contrad ir
March 1, curtent year
�Ti�
If name on record is difierent than that of applicant,
of mortgagee or contrad seller
Address of mortgagee or contrad seller
assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP
aty, state, ZIP
Record number O �
Page number � .Z
J
as of Is the applicant the sole legal or equitable
owneR ❑ Yes ❑ No
with someone other lhan spouse, indicate with whom.
�
,08-750
property in question:
❑ Real
Dces applicaM own property in any other If yes, what clumw� ��•-- —
county in Indiana? /� '
DI':l\tlCl' �D.�s./• .V �.... ,
� C:ICC� �� . ..................... �.
Deduction approved in the amount of:
zo �_ za 0�
� P
Signature
�
County Auditor
% (� `"n' ' �
I 20
a
20
❑ Mobile Horrie QC 61.1
� this dedudion been requested on
�erty for current yeaf? � Yes 0 No
Dale
20
certify under the penalty of perjury thal lhe above and foregoing infortnation is true and corred and that the applicants was / were
ient of Indiana and owner of the aforementioned property on March 1, 20
Full resident address of ap�ipnpt �
�- � � g � S�A-� 4-GY. ip't P�✓1c3,%Zn T1N
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Address of authorized person