HomeMy WebLinkAboutMortgage_Richardville�i� STATEMENT OFMORTGAGE OR CONTRACTINDEdi�UNESS
�' FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
!• State Fwm 43709 (R6 / SO6) • .
� Aesaibed by Department of Loql Govemmeni Finance —
iNSrRUCnoNS: JUN 0 12�d�Mar�
To 6e filed in person or by mail with the County Auditor of the county vihere the property is located. �
Filing Dates: 1) Real P�opeRy: During the 12 months befoie June I1 0/ the yea� lhe deduction is to be e(fective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the �/6e d�'tl��n is to be eKective.
See reverse side for additional instructions and qualifications. OIB90N COUNTY UDIiO�
see
Taxing Distrid
side)
Key number / legal description
number
Page number v I
� � 6- 3- oa- .a�afl� 3333
Assessed value ot real property as of MoRgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or e
March 1, wrrent year March 1, current year owneR � Yes ❑ No
i
If no, whaf is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diHerent than that of applicant, indicate below: Is the property in question:
of mortgagee or contrad seller
Address of mortgagee ar contraG seller (number and s12et, city, state, ZIP
Name of assignee or other owner or holdf "
' ` ��/j0 3333
ofassignee(numberandstreet, DC�\VCI'�T�..°.:4/...�-.....
Does applicant own property in any other Car(j \'�.
county in Indiana? � �0
�P»���w, �A� 99, ui9.
Deductior� appro� ed in the amount of:
20 D � 20 _a$_ 20
�
Signature
COUNTY AUDITOR
20
�
_ County Auditor
20
❑ Real Properry ❑ Mobile Home QC 6
Has this deduction been requested on
properiy for wrrent year? � Yes 0 No
20
Date
�
We certify under the penalty of peryury that the above and foregoing information is true and correct and thal ihe applicants was / were
residenl of Indiana and owner of the aforementioned property on March t, 20
� I i .� /� `� i n `
resident
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ress o authqrized person
�! 6 � o