HomeMy WebLinkAboutMortgage_Longbons�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS �-
FOR DEDUCTION FROM ASSESSED VALUATION C q Tow` 'p Year .
�� �.w� ! State Form 43709 (R514-03) ' ,L/
� PresaiEed by Department ol Loral Govemment Finance
�b
INSTRUCTIONS: `-�-., F�le AN4a�
To 6e filed in person or 6y mail with the County Auditor of the county where the property is located. l� �� 0'
Filing Dates: 1) Reaf Property: During the 12 months betore May 11 o/the year the deduction is to be �t86f�. COUNTY AUDITOR
2J Mobile Homes assessed under IC 6-1.1-7: 8etween January 15 and March 2 of the year the deduction is to 6e effective.
See reverse side for additional instructions and qualificatrons.
09b-Oa�
Or�-�9/-�
Mortgage / Contract indebtedness unpaid as
March 1, wrrent year
�`�, auo
indicate below:
Rewrd number
Page number
Is the applicant the sole legal or equitable
ownef? ❑ Yes ❑ No
If owned with someone olher than spouse, indicate with whom.
�
i er and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of
st�eet, city, state, ZIP code)
Does----`---• �-��^��•�� �.,.arti nther.l If.ves. what counry? What Taxing Dislnct?
couni ���!GQCNS /�%� �.�ilit �
/ � �J�j COUNTYAUDITOR
Dede �� � r..' l�
20
Signature
20 �
20 �� 20 20
County Auditor
s the property in question:
� Real Property ❑ Mobile Home QC 61.
Has this dedudion been requested on
properly for current yea(? � Yes ❑ No
20
Date
20
We certify under the penaity of perjury ihat the above and foregoing in(ormation is true and corred and that the applicants was / were
�esident of Indiana and owner of the aforementioned properiy on March 1, 2�
�
I � I so�
Person authorized by duty executed Power of
or by IC 6-1.1-12-.07
Address of authorized person