HomeMy WebLinkAboutMortgage_Zeisler�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. / State Form 43709 (RS / 4-03) '��, -{-•,� �,!
� I�� PreSaiDed by Departmeni of Loral Govemmen� Finance � {1 �1 j}-j �
� E �� � �� �
lNSTRUCTIONS: AUI7 � �Fi���ic
To be filed in person or by mail wdh the County Auditor of the county where the property is located.�
Filin Dates: 1 Real Pro e Durin the 12 months before Ma 11 0/ the �
g ) p rty: g y year the deduction is to-be eRectiver
2J Mobile Homes assessed under IC 6-1 J-7: Between January 15 and March 2 of tlie-year,the deducfion is_fo e effective.
See reverse side for addilional instroctions and qualifrcafions. '� GiBSON C�:,J�V'Y AUnI7Gft�
Applicant (o� r or contiact buyer- see restri 'ons on rse side) ,
�
Tacing Distri ey num r/ legal description Record number ��
�O / _ � �� / �� ^� Page number ���
IO �y C�CJ
Assessed value of real property as f Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currenl year March 1, current year owne�? ❑ Yes ❑ No
If no, what is his / her exact share of interest? If owned with someone olher than spouse, indicate with whom.
If name on record is different than ihat of applicant, indicate below: Is the propeRy in question:
❑ Real RopeAy ❑ Mobile Home QC 61.1-�
�ame of mortgagee or conlrad seller
Address of mortgagee or contract selier (number and street, p, state, ZIP
— S—
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant awn property in any olher If yes, what counry? What Taxing Distriq? Has this deduclion been requested on
county in Indiana? property for current yeaf? � Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
20 Ql� 20U � 20 �� 20 � 20 20 20
-� � P
Signature County Auditor Date
�� W rtify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
e t of Indiana and owner of aforementioned property on March 1, 20
natu owners full na e) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ul s ent address of applicant Address of authorized person
1