HomeMy WebLinkAboutMortgage_Weber (4)�
STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
S / State Fwm a3709 (R5 / a-03)
�M
PrescnDed by Departmem of Local Govemment Finaxa
Coun Township Year
INSTRUCTIONS: File•,Ma[k
To be filed in person or 6y mail with the County Auditor of the county where the property is 1� ated.� � ��� �
Filing Dates: 1) Real Property: During the 12 months before May 11 0/ the year the deduction�to e e�ecUv n J �iJ
2) Mo6ile Homes assessed under IC 6-1.1 J: Between January 15 and Maich 2g/ tbe�ear•the deduction rs to be eflective.
See reverse side for additronal insbuctions and qualiTcations. 0 C.� z� 2003
Appllcant (owner or cont t buyer - see restnctions on reverse s' )
�-
Taxing Dislrict ey number / leg e
Assessed value of real property as of Mortgage / Contract ir
March 1, current year March 1, current year
Ii no, what is his / her exact share of
If name on record is difterent
oi mortgagee or contract
s
below:
I _ �
Page number �
_ re�
as
Is the applicant the sole legal
owner? �s ❑ No
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seiler (number and street city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address
street, ciry, state,
operty in question:
Property ❑ Mobile Home (IC �1.
� — -- ._
,ver NO ...................
�y- 3��i -
d NO . ..............
Does appficant own property in any other If yes, what county? What Taxing Dis �6+-� E w�b �2 � i requested on
county in Indiana? S�/� /�� r? ❑ Yes❑ No
tG
COUNTY AUDITOR
Deduction approved in the amount of:
��/fi�m�6
20 ��
P
County Auditor
20 �_ 20 �, 20
P �
Date
certify under the penalty of perjury that the above and foregoing infortnation is true and correct and that the applicants was / were
ient of Indiana and owner of the atorementioned property on March 1, 20
Power
ar by IC 6-1.1-12-.07
resident address of applicant _ �Address of authorized person