HomeMy WebLinkAboutMortgage_Rexing (3)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
L ! State Fwm 43709 (RS / 4-03) �� � �� �
�«•
� PrescriDed by Department of Lo�al Gtivemmenl Finance
INSTRUCTIONS: MAR Eile)A�4
To be filed in person or by mail with the CountyAuditor of the county where the property is located. �
Filing Dates: 1) Real Property: Dunng fhe 12 months before May 11 of the year the deduction is to be'eflective. ��
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ tbe�year the deductron is,to 6e�ve.
G15S(� J;; �lt �� 7 v p.UC1T0:: .
See reverse side /or additional instnrctions and qualifications.
Taxing Distrid
Assess�value of
March 1. curcent v�
contract buyer- see
property as
no, what is his / her exact share of interest?
on reverse side)
Key numberJY legal description Record number Q�
_ Page number t a 3�
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, currenl year owner? �s ❑ No
If name on record is different lhan that of applicant, indicate below:
of mortgagee or contrad seller
owned with someone other than spouse, indicate with whom.
Address of mort�qee or contrect seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
I\s ^the property in question:
�teal Property ❑ Mobile Home pC 61.1
Address of assignee (numbe�and st2et, city, state, ZIP code) Drawer NO .............
......
Does applicant own property in any other If yes, what county? Ca rd NO. ...Y. ,��/� �.� requested on
county in Indiana? .• •. •• ? � Yes� No
COUNTY AUDITOR
Deduction approved in the amount
20
Signature
20 jZ(� I 20 � I 20 ��
County Auditor
20 � I 20
20
We certify under the penalty of perjury that the above and foregoing infortnation is lrue and coned and lhat the applicants was / were
resideni of Indiana and owner of the aforementioned property on March 1, 20
�na� (owners Iull name) � ' Person authorized by duly executed Power of Attomey
� � �L � or by IC 6-1.1-12-.07
1����- n t�l'T1°yA�I~a°�ess ot auinonzea person