HomeMy WebLinkAboutMortgage_Taylor (5)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' � FOR DEDUCTION FROM ASSESSED VALUATION
S J State Fwm 43709 (R4 / 10-07)
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� Prescribetl by DepaNnent of local Govemment Finance
Coun Township Year
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INSTRUCTIONS: F1'le
To 6e (led in person or by mail with the County Auditor of the county whe2 the propeify is located. AP R 2 3�
Filing Dates: 1) Real PropeRy: During the 12 months belore May 11 0l the year the deduction is to be e/%ctive. �� � ��
2) Mobile Homes assessed under IC 6-1.1-7: Befween January 15 and Maich 31 0l th� year the deduction is to be eHective.
See reverse side (or additional instruc6ons and quali�catlons. "�����~ r��
GIBSON r`?; t=:- . .
or contract buyer
� /l.��t�� %�(_G�J
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of interest?
on
Key number / legal
V �
���- � %� —�C� `
MoRgage / Contrad indebtedness unpaid as of
March 1, current year
name on record is difFerent than that of applicant, indicate below:
mortgagee or contrad
If
: number
Is the appliqnt the sole legal or
owneR ❑ Yes ❑ No
with someone other than spouse, indicate with whom.
' �/ 3 _ —
Address of mortgagee or con ct seiler (nw
�?-8�4y
Name of assignee or other owner or holder �j 35, sco. �°�
Address of assignee (number and street, c ��"' '�` ��
��Orr�j F�, �-
A�+,� A . ��'a�
Does applicant own property in any other it yes, w��a� ,,,,...,., . axing District?
county in Indiana? , �
Deduction appraved in the amount of:
20 Q,� 20
�
Signature
COUNTY AUDITOR
20 n�f 20 O� 20 O
County Auditor �
0�'`6�95.
the orooertv in aue<
❑ Real Property ❑ Moble Home (IC 61.1-
Has this deduction been requested on
property for wrrent yeaf? � Yes � No
20 Q�
Date �
20
/ We certify under ihe penalty of perjury that the above and foregoing infortnalion is true and corred and that lhe applicants was / were
� resident of.�ndiana 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 authorized person