HomeMy WebLinkAboutMortgage_Taylor (6)I�� _ J
rt�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' : FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�, y State Form a3709 (Ra / t P47 J
��� PrescribeA by DepaM�enl of Local Govemment Finance /� 3 i o a��O �
' / i r
�
INSTRUCTIONS: � � �� � File Mark
To be filed in person or by mail with the County Auditor o/ the county where the rope � t
Filing Dates: 1) Real Prope�ty: During the 12 months before May 11 0l the year the deduction is to be ef(ective.
2) Mobile Homes assessed under IC 61J-7: Behveen January 15 and Mt{r}�]j 3� o/ t���}�ar the deduction is to be eHective.
See 2verse side for additional instiuctions and qualifications_ / / k��� _
%�-�.;-E;f �-i��
Applic ownerorcontractbuyer-se sMcti o reverseside) �' G! �ONC�UNTYr.0 I rt i
Taxing District Key number / legal description Record number Q
��( � � m ^,�� Page number O
�� � U �
Assessed value of real property as of MoRgage / Contrect indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, currenl year owneR ❑ Yes ❑ No
boa
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 differeni ihan that of applicanl, indicate below: Is the property in queslion:
❑ Reat Property ❑ Mobile Home (IC 61.1-�
�.ne of mortgagee or contract seller
, % „
Address of mortgagee or conVact seller (number and st2et, city, state, ZIP
� n� � �- 59
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Dislrid? Has this deduction been requested on
counry in Indiana? property for curcent yea(?� Yes� No
COUNTY AUDITOR
Deduction approved in the amounl of:
20� zo zo o.r zoor� zo b� zo�$ zo_�
� P �
Signature County Auditor Date
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Si u(owne/s 11 na e) Person authorized by duly executed Power oi Attomey
' or by IC 6-1.1-12-.07
u sident address of appli _ t Address of authorized person
l.,.J �� 6 �
�