HomeMy WebLinkAboutMortgage_Yancey.�•na STATEMENT OF MORTGAGE OR CONTRACT
C ' P y
a;�' �" INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
" ' VALUATION State Form 43709 (1-90) Prescribed by the
St t B d fT C
Countv I T
s� ,e�• a e oar o ax ommissioners '
Instructions for filing: � �e
To be filed in person or by mail with the County Auditor of the county where the �:�9�.� .
property is located during the 12 months before May 11 of the year the deduction y�- .1 �ggg
is to be effective. See reverse for additional instructions and qualifications. �`� �
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(Owner or c�n�fact buyer - see restrictions on reverse)
Taxing District / � Ke�
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Assessed value of real property as Mortg
of March t, current year as of
If no, what is his/her exact share or interest?
mber/Legal Description
. c��es0��
Record No.
��
�
Year
— Page No. � �`J `v '�
(Contract Indebtedness unpaid Is the applicant the sole legal or
c� 1, current year. equitable owner? O yes O no
So-a . �L)
If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
e of mortgagee or contract
Address c?f mortgagee or contract
`_
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Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
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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? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
� s�G -oo i s 0 � i s�.g6�, �e�,� � 9 3
��i,,.1 � tc i_-2$'D � L- 9� „
1�Da•s'
Signature Secretary of Board of Review Date
�°� °d � P �� -� �� �
I/We certify under penalty o� perjury that the above and foregoing information is true and correct and that the appli-
,ynts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 .
/ �ure (owners full name) Person authorized by duly executed Power of Attorney or
„ Q,� � � � ,�_ ,, , by IC 6-1.1-12-.07).
ill Resident Address of
%Oy �•O�-�
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Address of Authorized Person