HomeMy WebLinkAboutMortgage_Hite.� "'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
Slate Form 43709 (RB / 2-07)
S � PreSa�betl by Department o} Local Govemment Fi�nca
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File a
INSTRUCTIONS:
To 6e filed in person orby mad wifh the CountyAuditor o/tne county wheia fhe pioperty is locafed. A'ifii 2 2 2006
Fding Dates: 1) Real Property.' Dumg the 12 months before June 11 W fhe year the deduction is to be elfective. -
2J Mobile Homes assessed under IC 6-7.7-7: Belween January 15 and March 2 o/the year tlie deduction is t 6e e(feclive.
See reverse side for additional insWctions and qualifications. �� ��
Apqica wneloroonLadbuyer-seeresfricfims reversesi0e)�� ��oavn�;UU�'11YAUDRO%
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Tapng �isViQ Key num6er / legal des�iption � Recortl number Page rnimber
a-�7-al-�oo-oo�,� v�- oa-1 aoo� 10��4
Assessed of real as d March 1, anent y�r MMgage / Contracl'vitlebtedrinss unpaid as of Marrh 7. Is Ihe app6mnf lha sde legal n equitahle mme(1
ainent year �^ / p
� ��Y�� �� (�00 ❑Yes ❑No
.���hat is his / her exad share ot inlerest7 If rnvned wilh someone dher ihan spouse, i�rate with whom.
on record is diRerent Ihan Ihat
Name ot mortgagee or canlract
rtrortgagee or conUatl seller (number ar�tl stmef. tity. sfafe. and ZIP crode)
essi9rree a oltia owner w hdder of rtrorlc e
Address of assgrree (mm�be� ard slreeC dty. sfa(e.
Does applicant own property in arry olher
counry in Inda�7
❑ Yes ❑ No
Deduction approved in lhe amount of:
�
SigraW re of County Audifnr
20
If yes, whal counry?
Is Ihe properly in questim:
❑ Real Pmperty ❑ Mobile Home (IC 61.
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COUNTYAUDITOR
20 20 20
Counry
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20
I I We certify under the penalty oi perjury fhat Me above and foregoing information is true and correU and that the applicanfs was / were a resident o(
Indiana and owner of fhe afwementioned property on March 1, 20
�e (Jq�e/s M1dl name) /� ' � . '� Date (monN. aaY Y��
Y ��
address af applicard
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n muwmey w nv ic �i i-�z-.o�
af aWwr¢ed pasan (numberane streeC cdy, state. ane
Oafe (manlh. day, yean