HomeMy WebLinkAboutMortgage_Krutz�--
�a `� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION
J State Fwm 43709 (R6 / 5-06)
� Aescnbed by Depanment of Lopl Govemment Finance
Count Township Year
� ��
JUN 2
INSTRUCTlONS: 5 ��wlaric
To be filed in pe�son or by mail with the County Auditor of the county where the propeRy is located.
Filing Dates: i) Real P�operty: During the 12 months before June ! 1 0/ the yea� [he deduction is to be e� � ,Q
2) Mo6ile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 of tF�e���8 N C�NTY��DITOR effective.
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See reverse side for additional instructions and qualifications.
Appl' nt (ownerorcrontract yer- see restrictions on rse side) .
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Taxing Dislrid Key number / legal description Record number
Page number
�.�, • a6 -/9-i9 -io/-odo ��P-oa�
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is lhe appli
March 1, current year March 1, current year owne(?
//Co, Sda_OU
If no, what is his / her exad share of interesl?
If name on record is different than Ihat of applicanl, indicate below:
of mortgagee or contrad seller �/�
Address of mortgagee or contrad seller (number and stieet, ci
or other owner or holder of moRgage
of assignee (num6erand sf�eet, city, state, ZIP code)
Does applicant own property in any other I If yes, what county?
county in Indiana?
approved in the amount
zo� I za
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Signature
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County Audit
/ We certify under the penalty of peryury that the above and fon
resident of Indiana and owner of the aforementioned property
resideN address of applicant
S'G 0 So uT � Cf.✓r?7 SYi�ltT FaPT lfiPa.�.c �
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3nt the sole legal or equitable
❑ Yes ❑ No
Ii owned with someone other than spouse, indicate with whom.
❑ Real Properiy ❑ Mobile Home (IC 61.1
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