HomeMy WebLinkAboutMortgage_Wallace (2)�.,,.F
r�_
• S'+�`d
�
('
STATEMENT OF MORTGAGE OR CONTRACT
INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
State Board of Tax Commissioners
Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the
property is located during the 12 moriths before May 11 of the year the deduction
is to be effective. See reverse tor additional instructions and qualifications.
NOV 3 0 2000
GIB/�NTY AUDITOR
Applicant (Owner or contract buyer - see restrictions on reverse) �
�
Taxing District _ Key Number/Legal Description Record No. c� .
l�l_J�-e� ' Page No. (o
Assessed value of real property as MortgagelContract Indebtedness unpaid Is the applicant.the sole legal or
of March t, current year as of March 1, current year. equitable owner? O yes �] no
3 0
If no, what is hislher�exact share or interest? • If owned with someone other than spouse,
6- � �q-ao�-�1�3lo-oa� indicatewithwhom.
If name on record is different than that of applicant, indicate below:
Name of mortgagee or contract seller '
Address of mortgagee or contract seller '
Name of Assignee or other owner or holder of Moitgage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? � yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19_�� {�b9� "�,% �� 19 � 19 19 19_�
,,,.o, P.�� � P
Signature ('�A �9 _ Secretary of Board of Review Date
� 'P
1/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
' nts waslwere a resident of Indiana and owner of the aforementioned property on March 1, 19
..�g ture (owners full name) Person authorized by duly executed Power of Attorney or
���y,�_ by IC 6-1.1-12-.07). �
II Residen�Address of Aplicant Address of Authorized Person
el � Aa1 � �XM�M� SriJ