HomeMy WebLinkAboutMortgage_ParidaenSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
� M� � state F«m aa709 (R5 � a-03) �
`� P25cribeC by DepartmeM of locai Govemment Finance �
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INSTRUCTIONS: � File Mark
To be filed in person or 6y mail whA the CountyAuditor of the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months before May 11 0/ the year the deduction is to be e/fective.
2) Mo6ile Homes assessed under IC 6-1.1-Y: Between January 15 and Ma�ch 2 0/ the year fAe deduction is to 6e effective.
See reverse side Ior additional instnictions and qualifications.
(owner
Taxing D�� //�
!/
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of
t�ns on reverse s�de) o
�Q�t1�yr / C;��.^�
Key number / legal description Record number �
� / /_ D O � � /�- y�� Page number / /�
'7 / C.J l�
MoAgage / Contrect indebtedness unPaid as of Is the applicant the s le legal or equitable
March 1, current year ownef? ❑ Yes ❑ No
/ Vv`�
If owned with someone other than spouse, indicate wilh whom.
If name on record is different ihan thaf of applicanl, indicate below:
moRgagee or contract seller
Address of mortgagee or cont�ad seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does applipnt own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amounf of:
20
Signature
� �'
What Taxing District?
COUNTY AUDITOR
20 bS 20 20
�
County Auditor
❑ Real
❑ Mobile Home
Has this deduction been requested on
property for current yeaR � Yes ❑ No
�
Date
20
certify under the penalty of perjury that the above and foregoing information is [rue and corred and that the applicants was / were
IenAof Indi�na and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of aulhorized person