HomeMy WebLinkAboutMortgage_Neufelderrt�' � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-° t FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S J Slale Form a3709 (R4 / 10-07)
�«.
� PrescriDeE by Depanment of local Govemment Pinance
�: 1
INSTRUCTIONS: � � �ile�rk
To be filed in person or by mail with fhe County Auditor o/ the county whe2 fhe prapeRy is located.
Filing Dates: 1) Real Property: During the 12 months befo2 May 11 of the year the deduction is to e effective.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0/ the year� �ec,u�jo�(�ao be eHective.
See �everse side /or additional rnstructions and qualifications.
Applicant(ownerorco t ct yer-see
Tazi Disirid
Assessed value of real property as of
March 1, currenf year
If no, what is his / her exact share of
side)
Key number / legal
Record nu�jbe� O � -1
%� ^ O � C/ / Q� Page number O/ Q O
U �n / 0
MoAgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, curren�ear owner? ❑ Yes ❑ No
� oo��
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
Address of moKgagee or conUacl seller (number a�i'd stieef, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street, city, state. ZIP code)
Does applipnt own property in any other I If yes, what county?
counfy in Indiana?
� .x
Signature
approved in the amounf of:
If owned with someone other than spouse, indicate with whom.
ZIP
What Taxing Distrid?
COUNTY AUDITOR
„1,'���, �.
County
Is the property in question:
❑ Real Properry ❑ Mobile Home pC 61.1-�
Has lhis dedudion been requested on
property for current yeaR � Yes � No
zo os
�
Date
zo �_
n
/ We certify under the penalty of perjury that the above and toregoing information is lrue and correcl and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
ue (owners full name)
i e , _.F� iY
of appticant
in authorized by duly executed Power of Attorney
IC 6-t.1-12-.07
of authorized person