HomeMy WebLinkAboutMortgage_Singleton� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
ti• �! Sia:e Fortn 63709 (RS / 4-03) ' �
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Prescribed by Depanment of Local Govemment Finance
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INSTRUCTIONS: —� F FIile Mark"l ��
To be filed in person or by mail with the County Auditor ol the counry where the propeRy is located. �--� � p� �� ., .)
Filing Dates: 1) Real Property: Dunng the 12 months 6e%re May 11 0/ the year the deduciion is to be ellective. ��—•� 1Lf�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be effective.
See reverse side for additional instructions and qualifications. � � � � U Z��4
Applicant (owner or contract buyer- see restrictions on 2verse side)
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Taxing Distrid
Key number / legal description
Gi9SON
Record number
AUDITC: �
• Page number � /
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Assessed value of real property as of Morigage / Contrect indebtedness unpaid as of Is the applican the sole legal or equitable
March 1, current year March 1, wrrent year owneR [Q�s ❑ No
3� bo l
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diHerent than that of applicant, indicate below:
�'-me of mortgagee or conlreU seiler
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Address of mortgagee or cont seller (number and sfreet, city, state, ZIP
Name of assignee or
Address
owner or holder of mortgage
(numbe� and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxinc
county in Indiana?
Deduclion
20
Signature
the amounl of:
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COUNTY AUDITOR
20 O i 20 20
County Auditor
Property ❑ Mobile Home (IC 6-1.1-�
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20
Date
20
certiy under the penalty of peryury that the above and foregoing information is true and corred and that lhe applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
resident address of applicant U
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Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person
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