HomeMy WebLinkAboutMortgage_Compton� ��� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
`I;�@� FOR DEDUCTION FROM ASSESSED VALUATION
�S � / State Fortn d3709 (RS / 4-03)
• PrescribeC by Department of Local Govemment Finance
Coun Township Year
INSTRUCTIONS: � Fife M1ttTffark �.1
To be �led in person or by mail with the CountyAuditor of tAe county whe2 the propeRy is located. y�
Filing Dates: 1) Real Property: During fhe 12 months 6elore May 11 0/ the year the deduction is to be e/iective. �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deductiN ,jsVto be elf� e.
See reverse side /or additional instructions and qualifications. _ � 3 2003
Applicant (owner or contrect
Taxing District
Assessed value of real
March 1, cunent year
see tnctlons on reve�
Key number /
as ot
If no, what is his / her exact share of interest?
GIBSOrJ �JOUN;4
Record number � ^
L
� Q� Q�/�%% ov Page number Q��
i 6 ('
Mortgage / Contract indebtedness unpaid as of Is the applicant t e sole legal or equitable
March 7, current year � 9� Q� owner? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applirant, indicate below:
of mortgagee ar contrecl seller
of mortgagee or contrect seller (number and street, city, state, ZIP
of assignee or other owner or holder of mortgage
of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any other I If yes, what county? What Taxing District?
county in Indiana?
Deduction approved in the amount
20
Signature
COUNTY AUDITOR
20 6� I 20 � I 20
�} �3a�
Counry Audiror
20
s lhe property in question:
❑ Real Property ❑ Mobile Home (IC E1.1-7)
Has this deduction been requested on
property for curcent year? ❑ Yes � No
20 O� '20 �
�
Date
certify under the penaity o( perjury that the above and foregoing information is true and correct and that the applicants was / were
ent of Indiana and owner of the a(orementioned property on March 1, 20
Person authorized by duly executed
or by IC 6-1.1-12-.07
sident address ot appNcant Address of authonzed person
3 �ox sai e� ,,..�.__._ „ � „-„_, ._