HomeMy WebLinkAboutMortgage_Racine�E,�•4 STATEMENT OF MORTGAGE OR CONTRACT
���n�` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
•.�' VALUATION State Form 43709 (1-90) Prescribed by the
.--�e�• State Board of Tax Commissioners
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Instructions for filing: \�v
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 tFie deduction
is to be effective. See reverse for additional instructions and qualifications.
File Mark
�����
SEP 8 1992
Applic nt (Owner or contract buyer - see restrictio s reve �se) �� �
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Taxing District Key Numbe /Legal Description Record No. ,7 ,!
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�' � age No. 1 3 i� ,S 9,3
Assessed value of reai property as Mortgage/Contract Indebtedness unpaid Is the applicant the sol legal or
of March t, current year as of March 1, current year. equitable owner? � es ❑ no
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If no, what is hislher exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
Name of o gagee or contract sel r ,
_ �
ddres of mort gee or contr ct eller
Name of Assignee or other owner or holder of Mortcfage.
Address of Assignee
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiane? requested on property for current
year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19��%� 19_�� 19�� �� 19 19 a? fJ �%1 '�Q ��-O.� �QQ�� f!�
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Signature��` Secreta � f� rd of�e�w �a��� � id � D�
6���✓ � � � � s
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�� ts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 .
:�ture (owners full name) Person authorized by duly executed Power of Attorney or
' by IC 6-1.1-12-.07).
F Reside t Address of Apl' -3 ` 7 ddress of Authorized Person
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