HomeMy WebLinkAboutMortgage_Mustard`°�"�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS �
i"° -' FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
�. • � J SUte FOrtn 43709 (R4 / 10.01) ' �
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� Prescribed by Departmen� of Local Govemmeni Finance ��
INSTRUCTIONS: MAR 1 H FOO �a�
To be filed in person or by mail with the County Audifor of the county whe2 the praperty is !oc ed.
Filing Dates: 1) Real PropeRy: During the 12 months be(ore May 11 0/ the yea� the deduction to be eftes�e�,.;�
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2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 y� r deductionis�fo 6e el/ective.
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See reverse side lor additional instruclions and qualifications.
Applicant (owner or contract buyer- s restrictions on reverse side)
Taxing District Key number / legal escription Record number
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Page number
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Assesse value of rea roperty as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, wrrent year owner? C'�]'es ❑ No
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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 different than Ihai of applicanl, indicate below: Is the property in question:
eal Property ❑ Mobile Home (IC 67.1-�
�3me of mortgagee or contrad seller
Address of mortgagee or contract selier (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appliqnt own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for cunent yeaR � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
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Signature County Auditor � Date
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�+✓ We certify under the penalty of perjury that the above and foregoing informalion is true and correct and thal ihe applicants was / were
� resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (ow rs (ull name) `�� Person authorized by duly execuled Power of Attomey
or by IC 6-1.1-12-.07
Fu resi en address of applipnt Address of authorized person
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