HomeMy WebLinkAboutMortgage_Ping� � STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
� � FOR DEDUCTION FROM ASSESSED VALUATION Coun T ship Year
'" ! Stata form 43709 (R6 / 5-06) ,{ O�\�(1
Presaibed by Depenment of Local Govemment Finance \
�•
MAY 2 9 2007
INSTRUCTIONS: File Mark
To be filed in person or by mail with fhe County Auditor of the county where the propeRy is located.
Filing Dates: 1) Real Property: Dunng the 12 months before June f 1 of the year the deduction is to b�"rcecfiv�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and Maich 2 oGIBSU�cUU��� T�� be elfective.
See reverse side for additional insfnic6ons and qual8ications.
Taxing District
�,,-/ see iestrictions on reverse si�
'f— %
Key nu er/legal
7/ _ Irl_I�i_ bn
Assessed value ofreal property as of
March 1, current year
If no, what is his / her exact share of interest?
name on
Mortgage / Contract ir
March 1, current year
.�, D DC�
than that of applicant, indicate below:
mortgagee or contract seller �
Record number � nO 7
/�v
Page number � � Y
iid as of Is the applicant the sole legal or
awner? 0 Yes � No
If owned with someone c�=•-�_�
oi mortgagee or contract seller (number and sheet, city, sfate,
assignee or other owner or holder of mwtgage
of assignee (number and street, city, state, Z!P code)
Does applicant own property in any other I Ii yes, what county? I What Taxing District?
county in Indiana?
20
Signature
approved in the amount of:
r� / ,
COUNTY AUDITOR
20 � 20 20
0
�
County Auditor
whom.
,)�,' '-
Dra�►�er NO.d�!v"%:��.�5
� • � \ ..J � r �
Card NO. ....:....
............
O.cJ/� sv,000. ��
Has this deduc6on been requested on
property for current yeaf? Q Yes❑ No
20
Date
20
�
We certity under the penalty of perjury that the above and foregoing infortnation is We and correct and that the applicants was / were
�asident of Indiana and owner of the aforementioned property on March t, 20
0
t ��ci
ti%i
or by IC 6-1.1-12-.07
of authorized person