HomeMy WebLinkAboutMortgage_Weisheit� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS �
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
t. N� J State Form 43709 (R5 / 4-03) ��`�j '��.s,—`
� PrescriDed Dy Department of Local Govemment Finance � �.] k
�NSrRUCnoNS: S�P 1 ����
To be filed in person or by mail with the County Auditor o/ the county where the property is locate ,
Filing Dates: 1) Real Property: Dunng the 12 months belore May 11 of the year the deduction is 6e eflectiv . //// n �
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0( i�-e,�s-'j_b; be �ffective.
See reverse side for additional instructions and qualifrcations. GIBSUN C`OtL� ; y q�p; ;��h j
Applicant ( r or c ntract bu er - see st ' tions on reverse sid .
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Taxing Distrid Key number / lega description Record number ��
�D� D/� Q/ � Page number ��D
Ass ssed v I of real pr as of Mortgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or equitable
Mar 1, cu ent year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exaci share of interest? Ii owned with someone other than spouse, indicate with whom.
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If name on record is different than that of applicant, indicate below: 4s the property in question:
❑ Real PropeAy ❑ Mobile Home QC 61.1-�
�me of mortgagee or contract seiler
�2 �L 1�.. C°,
Address of mortgagee or contrad seller (number and s t, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for wrrent year?� Yes❑ No
COUNTY AUDITOR
Deduction approved in the amounl of:
20 0 20 20(ZC� 20 f�� 20 � 20 C� � 20
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Signature County Auditor Date
��/ We certify under the penalty of perjury that the above and foregoing infortnation is true and correcf and lhat the applicants was / were
resident of Indiana and owne of the aforementioned property on MarcFi 1, 20 -
Signat o er's full name) � Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07 � �
u resi e t address of app icant ddress of authorized person