HomeMy WebLinkAboutMortgage_Williamson (5).,1;".i,;� �
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STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
S�ate Form 43709 (R4 / 10-07 )
�Preunbetl by Department W Local Govemment Fu�ance
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INSTRUCTIONS:
To 6e filed in person or 6y mail with the County Auditor of the county where the praperty is located. ��Ar Q� 2003
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 0l the year the deduction is to be�elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 of the �ar t��ionis to be effective.
See reverse side foradditional instructions and qualifications. G�3SO;J COU;J7v �
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Applicant (owner or contract buyer- see 2strictions on reverse side)� .
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Taxing Distrid K u r/ legal escription Record number
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^ O� _�� Page number
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Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applica�e sole legal or equitabte
March 1, curcent year March 1, currenl year owneR Yes ❑ No
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If no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
eal PropeAy ❑ Mobile Horne (IC Cr1.1-�
`lame of mortgagee or contrad seller
Address of mortgagee or conVad selier (number and street, aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and st�eet, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing Dislrid? Has this dedudion been requested on
county in Indiana? property for current year? � Yes� No
COUNTY AUDITOR
Dedudion approved in the amount of:
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Signature County Auditor Date
/ We certify under the penalty of perjury that the above and foregoing infortnation is true and corcect and that the applicants was / were
resident of Indiana and owner of the aforementioned property on Marcn 1, 20
i ture (ow n ) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
F resident ad re 5 of a plica Address of authorized person
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