HomeMy WebLinkAboutMortgage_Bruce (9)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION C p Year
♦ / Sqte Fortn 43709 (RS / 6-03) , ,
PrescriDW by Depanmefrt ot Local Gtivemment Finance
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INSTRUCTIONS: Fi�e rk
To be filed in person or by mail with the County Auditor o! the county where the property is located. �o� ���
Filing Oates: 1) Real Property: During fhe 12 months before May 11 of the year fhe deduction is to ����iy�UNTY AUDITOR
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 2 o(the e 7eduction is to be elfective.
See reverse side /or additional instructions and quali�cations.
see
Tauing
Key
Record number
�.y %�� _O//n� �T Pagenumber
7/ r1v � —V CJ
Asse sed valu f real pro as of MoRgage / Contred indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, wrrent year March 1, currer}t-year owneR ❑ Yes ❑ No
l/
c�
If no, whal is his / her exact share af interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicanl,
of mortgagee or contrad
Address of mortgagee or contract seller (number and street,
below:
state, ZIP
Is the properiy in question:
❑ Real Properiy O Mobile Hane pC 61.1-
Name ot assignee or other owner or holder of moAgage
Address of assignee (num6er and street, city, state. ZIP �^a-`
� o o �: :���7
Does applicant own property in any olher If ye: D►'a\Yer N
county in Indiana?
Deduction approved in the amounl of:
20
Signature
20
� Card NO
�9��so
20 ,�� 20 ,�` `'� 20
�
County Auditor
Has this dedudion been requested on
�roperty for current year? �] Yes❑ No
20
20
We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned propeRy on March 1, 20
Person authorized by duly execuled Power of Attomey
or by IC 6-1.1-12-.07
�f aulhonzed person
3 �gn� 7