HomeMy WebLinkAboutMortgage_Weyer"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou vmshi Y
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 6-09)
S,«• f Presmtetl M DepaRmeM af lttal GovemmeM Fuarce p�y�
INSTRUCTIONS: ���0 �O
Fortn Ned wkh:
To 6e filed in person or by mail wiN the CountyAuditor or Counry Recoider of Ne county where the property is bcated.
Filing Dates: 7) Real Property: Mus! file durirg the year (or which fhe deduction is sought. ���
2) Mobile / Manufadu2d Homes rrot assessed as Real Property: Must file dunng the fweHe (72) months ��a
6efore March 31 0! each }rear the deduction is sought ��R
GI SO 0 �
See reverse side 7w additional instructions and qualificafions.
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er / legal tlesaiplion Remrd numbv Page numbu
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Abrtga9e / Contract irdebtedness unpaid as of Mortgage / Conraa'uWeMedness unpaiE as of Is ihe a0p�nt the sale
Ma�ch 1, current year datc af aPP��� kgal or epuitable oxnell
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If owne0 wiN someo� oNer than spouse. IMkate wtlh wl�nn
0. trMica[e 6ebw: ihe V�G�Y in Ouesum: Mmia%PSSesseE
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Madle Home (IC 61.1-7
mntraf2 se0er (numh� and straef, ury, sb�. aM LP code)
Name of assignee or oNU owner or hd0er of mortgage
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De�uction approved'ui the amount of.
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AuOitor
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COUNTY AUDITOR
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Counry
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1/ We certify under the penalry of perjury Nat the above and foregoing infortnalian is We and cortecl and Nat the applinnt is a resident o( IrWiana and
owner I cor�' cl buyerAf the a(wementiwied pro0erty on date application is filed.
7ruwre (o hdl na � 1 Da;e (monrh. daY. Yae�
rily, state. and ZIP oode)
authortzed Ey Outy ezecutetl Power of Attomey rn by
stdte, an0 LP cotle)
Date (marN, daY Y��