HomeMy WebLinkAboutMortgage_Hoehn�° STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S / Sltte FOrtn 43709 (R4 / 70-01)
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PrescribeA by Oepartment of Local Govemment Finance
INSTRUCTIONS MAY O 8F�) ��
To be filed in person or by mail with fhe County Auditor ol fhe county where the property is focated.
Filing Dates: 1 J Real Pioperty: During the 12 monfhs be%re May 11 of the year the deduction is be effectiv . %�
2) Mo6ile Homes assessed under IC 61.1-7: Behveen January 15 and Maich 31 o he year deddJ�'�tio—n�-i�s-���t�n- �b-e(�eflective.
See ieverse side /or additional instructions and qualifications. GI/�� t?v aUpITOR I
Applicant (owneror ct buyer- see restridi on rev rse side
Taxing Dislrid Key number / legal descriplion Record number ��
D�_ Q�/'� C �/y� Page number �
J J UL/
Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equilable
March 1, wrrent year March 1, current year �� /� ry owner? ❑ Yes ❑ No
/ /
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is dif(erent than that of applicant, indicate below: Is the property in question:
� � Real Property ❑ Mobile Horrie (IC 6-1.1-�
`�me of mortgagee or contrad seller
Address of mortgagee or conVact seller (n�mber 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 applipnt own property in any other If yes, what county? What Taxing District? Has this dedudion been requested on
county in Indiana? property for wrrent year? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 �_ 20 �_ 20 20 �(� 20 � 20 D S� 20
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Signature County Auddor Dale
I We certify under the penalty of perjury that the above and foregoing infortnation is irue and correct and lhat the applicants was I were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
Si atu (owners I name) Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
F resident address of applipnt Address of authorized person
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