HomeMy WebLinkAboutMortgage_Alan Sensmeier Farm Inc��'�°" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�--:. � FOR DEDUCTION FROM ASSESSED VALUATION
'�, �+ State Form 43709 (R I 12-99)
,...
� PresaiEetl by Stale Board of Tax Commissioners
InsUUCtions for filing:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year the deduction is to be effedive. See
reverse side for additional instructions and qualifications.
restnctions on reverse
Taxing District
�^ 1 `4_/ ' �./ �
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of intei
If name on record is different than that of
of mortgagee or contract seller
Key number / legal
Stoo
IL�
APR � 4 ��`^ark
G�B�ON C��\TY AU�
Record number
FORM 5
Year
�� — �0�� _� Pagenumber
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole Iegai or equitable
March 1, current year owneR ❑ Yes ❑ No
I g�, C�
If owned with someone other than spouse, indicate with whom.
indicate below: .
Address of mortgagee or contrad seller (number and st�eef, city, state, ZIP
Name of assignee or other owner or holder of mortgage
of assignee (number and st�eet, city, state, ZIP code)
Does applicani own real property in any If yes, what county? What Taxing District? Has this dedudion been requested on
other county in Indiana? property for current yea(? � YesO No
PROPERTY TAX ASSESSMENT BOARD OF APPEALS
approved in the amount
20 �
Signature
G;
20p�3 I 206(•e�
20 �a{
P'r� Odfl
Secretary of PTABOA
20
20 � I 20 O %
�
Date
/ We certify under the penalty of perjury that the above and foregoing information is true and wrred and that the applicants was / were
i resident of Indiana and owner of the aforementioned property on March t, 20 �
Person authorized by
or by IC 6-1.1-12-.07
� . �Address of authorized person
of Attomey