HomeMy WebLinkAboutMortgage_Manning (2).•�•n4 STATEMENT OF MORTGAGE OR CONTRACT Fili
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a�, ., INDEBTEDNESS FOR DEDUCTION FROM ASSESSED County
'� ' VALUATION State Form 43709 (1-90) Prescribed by the
�• ` State Board of Tax Commissioners �
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Instructions for filing: � �
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 �
is to be effective. See reverse for additional instructions and qualifications. �
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(O�w���ner or contrac buyer - see r ictions on reverse)
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Taxing District Key NumbedLe�l Description Record No. 5 QG
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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
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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 difierent than that of applicant, indicate below:
mortgagee or contract seller
of mortgagee or contract seller
Name of Assignee or other owner or
of Mortgage.
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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:
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�yere ! oe�
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of Board of Review Date py
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IlWe certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�� was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 .
Signature (owners full name) Person authorized by duly executed Power of Attorney or
�� �/,1 �j y�,/ , by IC 6-1.1-12-.07).
Full Resident Address of Aplicant Address of Authorized Person
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