HomeMy WebLinkAboutMortgage_Stocker� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
` FOR DEDUCTION FROM ASSESSED VALUATION Cou 7o ip Year
�'+ �w� J State Fwm 43709 (RS I 4-03) ���
� Presaihe0 Dy Department of Loral Govemment Finance
MAR 2 Z00)
INSTRUCTIONS: File Mark
To be filed in person or by mail with the County Auditor ol the counry where the propeRy is located. `� ��
Filing Dates: 1 j Real Property: Dunng the 12 montbs be(ore May i 1 of the year the deduction is to be eHec`Five. `�
2) Mobile Homes assessed under IC 6-1J-7: Between January 15 and March 2 a�t9E;qeaCtpe'daducti�is�fo be effective.
See reverse side lor additional instructions and quali�cations.
(owner
Taxing Distrid
buyer - see resfrictions on
Assessed value of real property as of
Marcb 1, wrrent year
no, what is his / her exac[ share of interest?
If name on record is different than ihat of
of mortgagee or contrad seller
Key number / legal description Record number
�-lJ.- Ilo-�o0 - 600. 0 76-ax) b�
Page number
�ic�' Q
Mortgage / Contrad indebledness unpaid as of Is the applicant�sole legal or equitable
March 1, current year owner? es ❑ No
indicate below:
mortgagee or contrad seller (number and street, city, st
Name oi assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what counry?
county in Indiana?
20
Signature
in the amount of:
20 � 20 0 ,
� Q
COUN"
If owned with someone olher than spouse, indicate with whom.
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20 ��
County Auditor
certify under the penalty of perjury that the above and forec
lent of Indiana and owner of the aforementioned property o
ire (owners fuil name)
. �.�;f�.�.( �_° ��.�„>
t address of applicant / �
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