HomeMy WebLinkAboutMortgage_Boyer/`e.� "�A� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'i'� FOR DEDUCTION FROM ASSESSED VALUATION � � I, s Year
��j• State Fortn 43709 (R6I5-06)
Presc�ibed by Deparimenl af Local Gwemmen� Finance
INSTRUCTIONS: � �F�Mark
To 6e filed in person or by mail with the County Auditor of the county whe2 the property is located.
Filing Dates: 1) Real Property: Dunng the 12 months befoie ,lune �1 of the year the deduction i�(g�i�� Y AUDITOR
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ fhe yea� the deduction is to be effective.
See �everse side for additional instructions and quali�catrons.
Applicant (own or contrdct bu er- see ricGons on reverse side)
Taxin Dis r� er / leg� descri i Re rd number �� 6
C�:II� (� 9 ( J�% �l Page number
� \(/ ' �'v /$ %
Assessed value of real property s of MoAgage / Contrad in btedness unpaid as of Is the applicant the sole legal or equitable
Mar 1, w y r���/ ,Q��O March 1, current year owneR 0 Yes ❑ No
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If no, what is is / her exact share of interest? If owned with someone other than spouse, indicate wilh whom.
6- ��- 3-aoo-ooa.a�-o S
If name on record is dif(erent than that of applicant, indicate below: Is the property in question:
❑ Real Pmperty _ � Mobile Home (IC 61.1-�
�lame of mortgagee or conVad seller ,� � • �
Address of mortgagee or contrad seller (number and stieet, city, at , ZIP s� )�,
Drawer NO..:?��S-:�.......
Name of assignee or other owner or holder of mortgage /(�-j F�/
l.Q p �
C(� 1 T0 . ...................
Address of assignee (numberand st2et, city, s[ate, ZIP code) .� �85��.��
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has lhis dedudion been requested on
county in Indiana? property for current yea(? � Yes ❑ No
COUNTY AUDITOR
Deducfion approved in the amount ot:
20 �� 20 �_ 20 �(� 20 20 20 20
�
Signature County Auddor Date
� I/ We certify under ihe penalty of perjury that the above and foregoing information is true and correcl and thal the applicants was / were
a resident of Indiana and owner of the aforemenlioned properiy on March 1, 20
Signature wners !u 1 na ) Person authorized by duly executed Power of Attomey
� � or by IC 6-1.1-12-.07
F I resident address applicant Address of authorized person
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