HomeMy WebLinkAboutMortgage_HillSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T ip Year
FOR DEDUCTION FROM ASSESSED VALUATION �
t State Form 43709 (RS l d-03)
� PtesaibetlbyDepaMeMOfLOmIGO�remmentFinance �q O A �oOc
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INSTRUCTIONS: `�jja�ile�l�
To be filed in person or by mail with the County Auditor o/ the county where the property is located. �
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 of the year the deduction is to be��.AD�COUNTY AUDiTOR
2J Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 end March 2 of the year the deduction is to be ef(ective.
See reverse side Ior additional instnrctions and qualfications.
Assesskd value of
March 1, current yi
see restric6ons on reverse side)
number / legal description
� '' �� 1y
property as of MoRgage / Cantrad indebtedness ur
March 1, current year
If no, what is his / her exacl share
name on record is different than ihat of applicant, indicate belov✓:
of mortgagee ar conVact seller
Record number
Page number
as of Is the appli
ownefT
iegai or
❑ No
If owned with someone other than spouse, indicate with whom.
Address of mortga�e or contrad selier (number and street, aty, state, ZIP
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 Taa
county in Indiana?
20 ��
the amount of:
r� /,
COUNTY AUDITOR
20� 20 20
� County Auditor
�!�
J E���-�Y � �T��-
.�? L0� S
O� ��� �
iZ�]
20
ed on
; ❑ No
; We certify under the penalry of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property an March 1, 20
3nature ners full name) Person authorized by duly executed Power of Attomey
. �,� �ljQ or by IC 6-1.1-12-.07
appliqnt _ �Address of authorized person