HomeMy WebLinkAboutMortgage_Sanders (2)e`° ��� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS '-
- � FOR DEDUCTION FROM ASSESSED VALUATION -�
� � � SUIe Form 43709 (R4 / 10.01) . � . � . r -
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Prescri0e0 by Deoartment ot Local Govemment Finance
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INSTRUCTIONS: ����;�-y���F.ile Mark
To 6e filed in person or by mail wifh lhe County Auditor o( the county where the property'is located. °�• � "
Filing Dates: 1) Real PropeRy: During the 12 months before May 11 of the year the deduction is to be elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0! the year fhe deduction is to 6e eflective.
See reverse side lor additional instructions and qualificaGons.
cont2ct 6uyer - see restrictions on reverse
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Taxing District
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Assessed value of real property as of
March 1, current year _.
If no, what is his / her exact share of interest?
Key number / tegal description ttewra numoer
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DO� — O I n�g �D Page number �
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Mortgage ! Contrad indebtedness unpaid as of Is the applicant lh sole legal or equitabl�
March 1, curtent year owneR �Yes ❑ No
��(ps� aOD.DD
If owned with someone other than spouse, indicate with whom.
If name on record is diHerent ihan that of applicant, indicate
'lame of mortgagee or conlrad seller
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Address o( moAgagee or contract seller (number and street, city, state, ZIP
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Name oi assignee or other owner or holder of mortgage
Address of assignee (numberand street, city, state, ZIP code)
s the property in question:
❑ Real Property ❑ Mobile Home QC 61.1 ;
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Does applicant own property in any other If yes, what county? I What Taxing Distrid? I Has this dedudion been requestea on
county in Indiana? property for current year? � Yes❑ Nc
Deduction approved in the amount ot:
20 � 20
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SignaWre
COUNTY AUDITOR
20 20 � �
County Audito�
20
20 � ' 20
Date �
I! We certify under the penalty of perjury.thal the above and foregoing information is true and correcl and that the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
iignature (owne s Iull nam _) C //� Person authorized by duly executed Power of Attomey
�/JA. �i w� � ).rn,� iV Ol�� or by IC 6-1.1-12-.07 ,
resident address ot applicant ruu�ca
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person