HomeMy WebLinkAboutMortgage_Maikranz/ee '�A� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
1\i•�; FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
—\� State Form 43709 (R6 / 546)
�,� Presaibetl by Depariment of Loml Govemment Finarice
JAN 0 5 2007
INSTRUCTIONS: File Maric
To be /iled in person o� by mail with the CountyAuditor o( the county where the property is located. �-y,,
Filing Dates: 1) Real Property: Dunng the 12 months be(ore June Il of the year the deduction is fo be �f/� �
2) Mobile Homes assessed under IC 6-1.7-7: Between January 15 and March 2 o/��Nt �ti ��e ef/ective.
See reverse side for additional instructions and qual�cations.
Applicant erqrcontract buyer- ee resMdi s n rev e side)
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Taxing Distrid Key numb r/ legal descri tion Record number
/'� �� ,?!c-/9-/P-30.3 ao. _a.LL
( /.L.L �\ Ji � n ,,,� ��� � � _ �(� Page number b //�
Y J i ��� �
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, current year March 1, current year O'i owne(? � Yes ❑ No
O �jV
I( no, what is his / her exacl share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in queslion:
❑ Real Property ❑ M�ile Hmie (IC 61.1-�
�me of mortgagee or contract seller
�
Address of mortgagee or contrad seller (number and street ci , state, ZIP
Name of assignee or other owner or holder of mortgage
Addres p code)
Dra�r�er NO�(1.9.'�.l„�„l�
Does a �unty? What Taxing Distrid? Has this dedudion been requested on
ty property for wnent yeaR �] Yes ❑ No
coun Card N�.
.....................
`�` 3a, �`oo, 6 �
COUNTY AUDITOR
Deduction approved in the amount of:
20 J' 20 �_ 20 20 20 20 20
�
Signature County Auditor Date
�We certify under the penalty of perjury that lhe above and foregoing information is true and corred and lhat lhe applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
Sig re owner rrie�- Person authorized by duly executed Power of Attomey
( or by IC 6-1.1-12-.07
�
Full resid address oi applip t Address of authorized person
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