HomeMy WebLinkAboutMortgage_Montz (2):� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
� �� FOR DEDUCTION FROM ASSESSED VALUATION
w� � State Fortn 43709 (R6 / 5-06)
� Prestribed by Deparimenl of Local Gwamment Finance
INSTRUCTIONS:
To 6e filed in person or by mail wdh fhe CountyAuditor of the county where the property is located .`
Filing Dates: i) Real PropeRy: Dunng the 12 months before June Il of the year the deduction is to be e��� 6 Z�08
2J Mo6ile Homes assessed unde� IC 6-1.1-7: Behveen January 15 and March 2 0l the year the deductlon is to be effective.
See reverse side for additional instruc6ons and qualifications. �j� ��
Q�BSON COUNTY pl�nirne
contract
Taxing
number /
Record number
/// _ ' O j%%� '� S Page number Q
1� 0 0�--
Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole egal or equitable
March t, current year March 1, current year owne(? ❑ Yes ❑ No
��
If no, what is his / her exad share of interest? If ned with someone other than spouse, indicate wilh whom.
If name on record is different Ihan ihat of applicant, indicate below:
e of mortgagee or contrad seller
�1'Yl. . � (�� �uZ �
Address of moRgagee or contract seller (number and st2 t dty, state, ZIP
Name ot assignee or other owner or holder of mortgage
Aatlress of asslgnee (number and st2et, city, state, ZIP code)
Does applipnt own property in any other If yes, what county?
county in Indiana?
Deduction approved in
20 C)
1
Signature
�
What Taxing Di
COUNTY AUDITOR
amounl of:
� 20 20 20
�
County Auditor
U
❑ Mobile Hortie QC 61.1-�
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20
Date
20
ify under the penalty of perjury that the above and foregoing information is We and corred and lhal the applicants was / were
of Indiana and owner of the aforementioned property on March 1, 20
� e/s (ull r�9m ) Person authorized by duly executed Power of Attomey
S�� or by IC 6-1.1-12-.07
res' ent address of�ppUqnt Address of authorized person
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