HomeMy WebLinkAboutMortgage_McReynolds`° � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�, I«.� � State Form 43709 (R4 / 10-Oi) � � �
PrescriEeG by Departmenl ot Local Govemment Finance � J
INSTRUCTIONS: �UL 1.rl ZOOZ FileMark
To be filed in person or by mail with the County Auditor ol the county where the property is Iocated.
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 0l the year the deducfio�o b�ffect,iv, ����%
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 a_ ��"`3��ey, a;�e�nduction is to be eHective.
See reverse side Ior additional instructions and qualifications.
Applicap( (owner or confract uyer- see �stnctions on reverse side)
�� � �J
Tauing Distrid Key number / legal description Record number
aoo a - 3 Sy�l
Page number
O l 7-�U
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, current year March 1, current year owneR ❑ Yes ❑ No
5o�9a
If no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicale below: Is the property in queslion:
� Real Property ❑ Mobile Home pC 6-1.1-�
�me of mortgagee or contract seller
O N ,O �� .
Address of mortgagee or contrad seller (number and st2et, city, state, ZIP � n��
�
Name of assignee or other owner or holder of mortgage
�1��3 �i
Address of assignee (num6er and street, city, state, ZIP code) �
Does applipnt own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
county in Indiana? property for wrtent yeaf? � YesO No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 Q[� 20 �% 20 �� 20 `
%;P�.oa� �° ,� O
ignature County Auditor Date
�� We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
ign tur owners full name) Person authorized by duly executed Power of Attomey
� � or by IC 6-1.1-12-.07
ull resident address of applicant Address of authorized person
/o �/ a�d,�t .