HomeMy WebLinkAboutMortgage_Neufelder (3),ae �� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`i•� FOR DEDUCTION FROM ASSESSED VALUATION sh Year
, 'v_w �J StateForm43709 (R6/5-06)
� Presoibed by Depariment of Lazl Govemment Finance
INSTRUCTIONS: � il Mark
To be filed in person or by mail with the County Auditor o/ the county where the p�operty is located. ��
Fi/ing Dates: 7) Real P�operty: DuAng the 12 months befo2 ,lune 17 0/ the year the deduction is to be /f Ct V
NTY,AUDITOR
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 75 and March 2 of t�����he educ6on is to be effective.
See reverse side for additional instruclions and qualifications.
Appl' (owner or coqtracf bu er - see restrictions on reverse side)
Gir- �
Taxing D' rid y number / legal description Record number O�
��, i���� �� �9��� ���- �OU.��o-D� Page number '7 J/
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Assessed vatue of real property as of Mortgage / Contract indebtedness unpaid as of Is ihe applicant ihe sole legal or equitable
March t, current year March 1, current year �o owneR ❑ Yes ❑ No
1�, 0 0a 8(,, D0�
If no, what is his / her exact 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: Q� A� S I,�E l� rt L p�2
IL « /�� �A•�-
1.1-�
me of mortgagee or contrad seller ��
Address of mortgagee or contrad seller (number and street, city, state, ZIP D�" a.J�
Name of assignee or other owner or holder of mortgage
Address of assignee (number and streef, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing District? Has this deduction been requested on
county in indiana? property for current yea(? � Yes ❑ No
COUNTY AUDITOR
Deduc6on approved in the amount of:
20 �$_ 20 Q`� 20 20 20 20 20
�
Signature ' County Auditor Date
�/ We certiy under lhe penalty of perjury that the above and foregoing information is true and corred and that ihe applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
Si natu (owners /ull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ulI ident address of applicant Address of authorized person
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