HomeMy WebLinkAboutMortgage_Finney/g�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i'�" FOR DEDUCTION FROM ASSESSED VALUATION o t T ip Year
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:.�+ State Fortn 43709 (R6 / 5-06) .
Presaibed by Depertment of Local Govemment Finarxe N � V � 2��6
INSTRUCTIONS: �' "`� `4�e Mark
To be filed in person or by mail with the CountyAuditor of the county where the property is /ocg�,ON COUNTY AUDITOR
Filing Dates: 1J Real Property: During the 12 months before June 11 0l the year lhe deduction is to be effective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 2 0( the year the deduction is to be elfective.
See reverse side for additional instructions and qual�cations.
(owner
Assessed value of real property As of
March 1, current year
reverse side)
Key number / le��l deScription
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Mortgage / Contrad indebtedness unpaid as
March 1, current year
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Record number
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Page number /O ' /
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Is the applicant the sole legal or equitable
owner? ❑ Yes ❑ No
If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.,
If name on record is dif(erent than that of applicant, indicate below: Is the property in queslion:
❑ Real Properiy ❑ Mobile Home (IC 61.1
me of mortgagee or contrad seller n� n
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Address of mortgagee or contrad seller (number and street, city, state, Z!P
assignee or other owner or holder of mortgage
Address of assignee (num6er and sLeet, city, state, ZIP code)
Does applicant own property in any other I If yes, what county? What Taxing Distrid?
cor_�. .- '-�`---'— -
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_ Dra�ver NO':.G.`.:'c::..........
COUNTY AUDITOR
De Card NO. ..O ? �:.�.� �%�
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_ County Auditor
Has this dedudion been requested on
propertyfior current �year? � Yes ❑ No
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20
We certify under the penalty of perjury that the above and foregoing information is We and corred and that the applicanls was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
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Fu�l resident ad
.b l� 9 5'
� of applipnt
5. a a �t�J
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person