HomeMy WebLinkAboutMortgage_Stevenson'� ��� y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
! Slate Fortn 43709 (R6 / 5-06)
� Presaibed by Department of Laal Govemment Finance
INSTRUCTIONS: 'j�` �e --�
To 6e �led in person or by mail with the County Auditor o( the county where the property is loc e ep ��
Filing Dates: 1) Real Property: Dunng the 12 months be%re ,lune 17 of the year the deduction�bc� ec �ve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deducGOn is to be eflective.
See reverse side fo� additional instnictions and quali�cations.
MAR u :: io�:�
`7�1� ,G'�'�
(owne� or contiact�y� - see resfRCtions on
Key number / legal description
COUNTY
Record number
��� \l� � Page number (�,
_ 2-1�-�o�b�D.�'i a�- `7�1 c�
Assessed value of real property as of MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, cu nl year owneR ❑ Yes ❑ No
�I 19c�
If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
name on record is different ihan that
of mortgagee or wniract seller
indicate below:
Address of mortgagee or contract selier (number and street, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Dces applipnt own property in any other I If yes, what county?
county in Indiana?
Deduction
20 0 i
,
Signature
Dra �ti er iVO. �/ _
...,,-•�v
Card i�; ��ja '• •.
�.51�19 Q;" •..
�°• -
ZIP
What Taxing Distrid?
COUNTY AUDITOR
uditor
20
s the property in quesfion:
❑ Real Properry ❑ Mobile Home QC 61.1-�
Has this dedudion been requested on
property for current yeaR � Yes 0 No
zo
zo
certify under the penalty of perjury that the above and foregoing information is true and corred and thal the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
name)
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
applipnl Address of authorized person
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