HomeMy WebLinkAboutMortgage_CrawfordSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
i�/ Sute Fortn 43709 (RS / 4-03) .
� Piescnbetl by Department of local Gtivemment finance
INSTRUCTIONS:
Coun Township Year
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File Mark
To 6e filed in person or by mail with the County Auditor of the counry where the property is located. F E B Q 9 2��4
Filing Dates: 1) Real Property: During [he 12 months be(ore May 11 0/ the year the deduction is to be e/fective.
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 2 0( tFie year the deduction is to be e/fective.
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See reverse side Ior additional instructions and qualifications. I^J, '
GtBSOri COUd i r .SUDi70R
Applicant (owner or ntract buyer- see re 'ctio s on reverse side)
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Taxing Dislrid Key nu gal description Record number O�
� �D �"'_ � S _QO Pagenumber
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Assessed value of real property as of MoAgage / Contred indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March 1, curtent year owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interesl? If owned with someone other fhan spouse, indicate with whom.
If name on record is different than lhat of applicant, indicate below `'°-�heDroperty in question:
1� ^ ^ - - � .1obile Home (IC 61.1-�
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�me of mortgagee or contrad seller � � ^ _ ,�j � �
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Address of moAgagee or contrad seller (number and st�eet, Gh v 3 /// �
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Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wnent yeaf7C� Yes� No
COUNTY AUDITOR
Deduction approved in the amounl of:
20 �� 20 Q�_ 20 �� 20 D� 20 � 20 20
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Signature County Auditor Date
' We certify under the penaliy of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
natur o ers ame) Person authorized by duty exewted Power of Attomey
or by IC 6-1.1-12-.07
Ful ident dress pplipnt Address of aulhorized person