HomeMy WebLinkAboutMortgage_Garrett (15)�T•�a STATEMENT OF MORTGAGE OR CONTRACT Filin fee $1.00
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?�; �° ;` INDEBTEDNESS FOR DEDUCTION FRGM ASSESSED
� � VALUATION State Form 43709 (1-90) Prescribed by the County Township Year
e�' State Board of Tax Commissioners
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Instructions for filing: � ��� ���k
To be filed in person or by mail with the County Auditor of the county where the �
property is located during the 12 months before May 11 of the year the deduction NOV 10 1997 �«�
is to be effective. See reverse for additional instructions and aualifications.
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Applicant (Owner or contract uy r- see restrictions on reverse) G:F."?"' ��'�'<' ``''��TOR
Taxing District Key Number/Legal Description Record No. q/
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� � —p(� Page No. " 'g,
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current year. equitable owner? O yes O no
�
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
'-�e of mortgagee or contract seller
Ad ss of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee .
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes ❑ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19 � 19���j-� 1� � 19 602 �Q�a3 1���y 1��
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Signature Secr�tary of Board of Review Date
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IlWe certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
r s was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 .
�ature (owners full name) Person authorized by duly executed Power of Attorney or
c�_ /1 � � � by IC 6-1.1-12-.07).
C �dlet
Full Resident Address of Aplicant Address of Authorized Person
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