HomeMy WebLinkAboutMortgage_Fisher (2)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun� Township Year
� Sfate Form 43709 (RS / a-03) p.�
�I PiesaiDeE by Department of �oral Guvemment Finance q��
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INSTRUCTIONS: '�A N 1 FRe �
To 6e filed in person or 6y mail wdh the CountyAuditor o7 the county where [he property is located.
Fifing Dates: 1) Real Property: Dunng the 12 months before May 11 of the year the deduction is to be eR�p,� �Q�
2) Mo6ile Homes assessed under IC 6-1J-7: Between January 15 and March 2 0/ the the deVirction o 6e effective.
���ON COUNTY AUDITOR
See reverse side for additional inst�uctions and quali�cations.
Applicant (o� or contract buyer- see rest 'c6ons on reverse side)
�
Taxing Distrid Key mber / I I description Record number
A� _� � Page number
v
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equilable
March 1, current year March 1, current year owne(? � Yes ❑ No
!G o
If no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different ihan that of applicant, indicale below: Is the property in question:
L�'Real Properly - � Mobile Home (IC 61.1-�
�me of moAgagee or contrad seller S/ --
Address of mortgagee or contract selier (number and st2et, city, stafe, ZIP — �� �j`_pJ
�'�'t4-� %� ,v.� —�
Name of assignee or other owner or holder of mortgage /%, qJ �, � r� /�"L0. ' 9�
��.�.«�7 � � , 2� �
98-�5�� /o oa�.o�
Address of assignee (num6er and strtet, city, state, ZIP code)
Dces appliqnt own property in any other If yes, what counry? What Taxing Distrid? Has this deduction been requested on
county in Indiana? , property for wrrent yea(? � Yes � No
�- _ 7 COUNTY AUDITOR
Dedudion approved in the amounl of:
20 D/ 20 I 20 � 20 20 20 20
T
/
Signature County Auditor Date
We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
. resident of Indiana and owner of ihe aforemenlioned property on March 1, 20
Si at re (owners full name) � Person authorized by duty exewted Power oi Atlomey
, �,�,,�,Q�,� or by IC 6-1.1-12-.07
Full resident a dr s of appliqnt Address of authorized person