HomeMy WebLinkAboutMortgage_Reed (2)`O�" STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
° 4 FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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. S j State Fortn a3709 (R4 / 70-01)
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PresaiDt,W by Depariment of Local Govemment Finance � a
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INSTRUCTIONS: File Mark
To be filed in person or by mail with fhe County Auditor o/ the counly wheie the property is I�a�� d 20�2
Filing Dates: f) Real Property: During the 12 months before May 11 0/ the year the de ction is to be elfective.
2) Mobile Homes assessed under IC 6-1J-7 Between January 15 and reh 31 of t y�� the daduc ' n is to 6e effective.
See reverse side /or additional instructions and qualifications. ��^ �„
GIESON COUtiTY .UDITOR
Applicant (ovmer or cont buy see r trictio s on reverse side)
Taxing Dislrid, Key number / legal description Record number
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- /'� ` _ O _ � Page number
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Assessed value of reai property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year ownef? ❑ Yes ❑ No
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If no, what is his / her exacl share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than thaf of applicanl, indicate betow: Is the property in question:
❑ Real Pmperty ❑ Mobile Hmie QC 61.1-�
me of mortgagee or contract seller,,
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Address of mortgagee or contrad seller (number an treet, city, state, ZIP
Name of assignee or other owner or holder of mortgage,
Address of assignee (number and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing District? Has this dedudion been requested on
county in Indiana? property for curcent year?� Yes� No
COUNTY AUDITOR
Deduction approved in ihe amount of:
zo �_ �- � 20 �.,�_ 2o zo 20 �(� zo �,'1 20 0
.5 p bA �
Sig re 0� County Auditor Date
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' We certify under the penalty of perjury that the above and foregoing information is true and corred and thal lhe applicants was / were
esident of Indiana and owner of the aforemenlioned property on March 1, 20
i nature (o er lull name) Person authorized by duty executed Power of Atlomey
or by IC 6-1.1-12-.07
ull resident addres of applicant Address of aulhorized person
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