HomeMy WebLinkAboutMortgage_Lowry�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' • FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
♦ � Stdte Fortn 43709 (R4/ 10-07)
�«•
i� PrewiOeC Dy Department of Loca� Govemment Finance
� F7--� r
INSTRUCTIONS: � � (j File�rk
To be filed in person or by maii with the County Auditor of the county where the properiy is located ����J
Filing Dates: 1) Real Property: During the 12 months be%�e May 11 of the year the deduc6on is to be e(/ective. nn
2) Mobile Homes assessed unde� IC 6-1.1-7: Behveen January 15 and March 31 0/ the year�Ndedur9,ti��J� be effective.
See reverse side (or additional instrucfions and qualiTca6ons.
(ownerorcontract buyer- see 2stridions on reverse
Taxing
Assessbd value of �al property as
March 1, wrrent year
no, what is his / her exad share of interesl?
If name on record is different than that
Key number / lega�
l )l� l � (� 1 f
Mortgage / CoNrad ir
March 1, current year
below:
e Record number
_ r� Page number 3
as
�
Is the applicant the sole legal or equitable
owneR �fes ❑ No
I
If owned with someone other than spouse, indicate with whom.
moAgagee or conVad seller
�Rgagee or conVact seller (number and st2et, city, sfate, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, sfate, ZIP
Does applipnt own property in any other If yes, what county? What Tauing Distrid?
county in Indiana?
COUNTY AUDITOR
Deduction approved in the amount of:
20 � I 20 �,� I 20 D� I 20 ,�J r1
County Auditor
20 b �
❑ Mobile Hmie
Has this dedudion been requested on
property for wrrent yeaR 0 Yes ❑ No
20�_ 20
/
/ We certify under lhe penalty of perjury thal lhe above and foregoing infortnalion is irue and corred and thal lhe applicants was / were
� resident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power
or by IC 6-1.1-12-.07
of authorized person