HomeMy WebLinkAboutMortgage_Whitee�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Yea
J State Fortn 43709 (R6 / 5-06) �
� Presaibed by Departmem of Loral Govemment Finarze
To beRfilued�'n�person or 6y mail with the County Auditor of the county where the property is /ocated. ��L.J Fil�e-MarK �
_tLl'
Filing Dates: 1) Real Properfy: During the 12 months befoie ,lune Il of fhe year the deduction is to be e ective.
2) Mobile Homes assessed unde� IC 6-1 J-7: Behveen January 15 and Maro6 2 of the yea the`�deductiol�l'SRo be effective.
See reverse side for additional instiuc6ons and quali/ications.
�l�<., ,Q�,
see iestnctlqrry on
Taxing District -��
�
Assess d value real prope s of
March 1, current year
Ii no, what is his / her exact share of interest?
AUDITOR
Key number / legal description 3��1 Record number
a�� /a3d-��Do;��- °?��
Page number
a
MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or e
March 1, curtent year � owner? Q Yes � No
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If owned with someone other than spouse, indicate with whom.
name on recorcl is different than that of applicant, indicate below:
P�: of mortgagee or contract seller
Address of mortgagee or contract seller
Name of assignee or other owner or holder of mortgage
Address of assignee (numbe� and sbeet, city, state, Z
Does applicant ovm property in any other If yes, what
county in Indiana?
Deduction
+Ii7
�
in the amount of:
20�_ 20
� �
�
❑ Real Propertv ❑ Mobile Home
state, ZIP
� � 6on been r
�1-��ti'C�' 1�`D.p� .. Irrentyear?
. �x�..r.-..��9a
C8� i\��.�
��Y�l.�E -
�6� (S'0, o� .
20 I 20
Counry Auditor
20
20
1-
on
INo
certify under the pena�ty of peryury that the above and foregoing infortnation is We and cortect and that the applicants was / were
fent of Indiana and owner of the aforementioned property on March 1, 20
ire (owners (ull e) � Person autfiorized by duly executed Power of Attomey
�� . ,� � or by IC 6-1.1-12-.07
0
person