HomeMy WebLinkAboutMortgage_Julian (4)°m STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
_ A FOR DEDUCTION FROM ASSESSED VALUATION ��
Slate Form 43709 (R8 / 2-07)
��' �� Resrnbed 6y Depanment ot Local Govemmenl Finance
w.
� File ylark,08
INSTRUCTIONS: uN 1 b LU
To be filed in person or 6y mad wrth the CountyAuditor o/ the courtty whe�e fhe piopeAy is bcated. �
Fd'a'g Dates: 1) Rea/ Property: During the 12 months befae June il o/ the year the deduction is fo be eBective.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 2 0l the }rea� the deduc6on is fo-9�.yJfecGv��
See reverse side lor additional inshuctions and qualifications. , O�� �
TY AUDIT�R
Applican�(o erwmn -sceere reverseside) /"\
T ,L%
Tannp�trict Key mim6er / legal descnption ^ Recnrd number Page number
Assessed valua of real papaly as of Mardi i. anenl Y� I��9e
aiRari
If�hat is his / ha enaU share of irherest?
If name on recwd is drfFerenl Ihan Ihat of applicant, indi�le below:
Name of nwrtgagee a onLad seller
Address of moAgagee or mn seller (numbu aM .Weet, oty, state,
Name of assignee a dha o.vner w holder of ma�ga9e
Address of assignee (num6el and sGee1.
Does applicant axn property in any olher
tounry in Indiara?
❑Yes ❑ No
Deductb� approved in the amount of:
.��L���
—U W "' ' V
I Coniracl iMeMedness unpaid as of March 1, Is
�/ 7/ %• s'
If wmed wi�h someane dher Ihan s�
If yes, whal couny7 What Ta�dng Dis4ic17
COUNTY AUDITOR
2p _ 2p _ 20 _
]le legal w equitade ame%
� ❑ NO
whom.
Is ihe praperry in questim:
❑ Real Pr4perty ❑ Mobile Home (IC 61.
Has Itus dedudia� bcen
fd arteni yPal?
20
on properry
s ❑ No
20
ireWre ot Camry fwdGOr' Counry I Date (lrmN. daY Y��
I I We certify under the penalty of perjury that the above and foregoing infomiation is true and corted and that tlie applicanfs was / were a resident of
Indiana and owner oi the atwementioned property on March 1, 20
mature fowne/s fiAI namel /1 � Date (monfh, day, yean
sfate, alM ZIP oode)
P auUarized by duy erzeated Power of fLLtomey a Dy IC 61.1-72-.07 " � ( Date (mmtlr, Oay.
AOdrwsofauUUr¢edpasm (num6eraMsbeeGcdy.sfate,arMLPmde)