HomeMy WebLinkAboutMortgage_RichmondSTATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
` w J Stata Form 13709 (RS / 4-03J
� PresviEad Cy Depenment of Local Govemment Finarxe
Coun Townshi Year
4 T.�
INSTRUCTIONS:
i �Ac
To be filed in person or by mail with the County Auditor of the county where the property is locafed. FEB 2 �
Filing Dafes: 1J Real Pr�perty: Dunng the 12 months be%re May 11 0/ fhe year the deduction is to be elfective.
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the yeai72r��u�N� fo be elfective.
�� �
See reverse side foradditional instructions and qualificaUons. G�gSON COUNTY AUDITOR
(owner or conhact buver - see
Tazing Distrid �
�`
Assessed value of real property as of
March 1, current year
If no, what is his / her exaa share ot interest?
If name on record is dfferent than that of appl
of mortgagee or contract seller
ins on
Key numbeY/ legal description Record number D
.2l0-/�-0/- ya`f -00�• o�s O�
QI ��,�j(jO�l 5",j�n Page number
l Vv ! �-CJ
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole le al or equitable
March t cunent year owneR ❑ Yes ❑ No
• I( owned with someone other than spouse, indicate with whom.
indirate below:
Address of mor�qagee or contrad seller (number artd sUeet, aly,
Name of assignee or
Address ot
Does appticaN own
county in Indiana?
DeducSon
20 O �
Signature
owner or holder of mortgage
(numberarrd st2et, city, state, LP oode)
ZIP
property in arry Wher If yes, what county? What Taxing DisVict?
COUNTY AUDITOR
in fhe artaunt of:
20 �� 2(1-In 9 20 20
County Audi[or
Is the pr
❑ Real
❑ Modle Home QC 61.
Has this deduriion been requested on
propeAy fw curteM yeart � Yes� No
20
20
ce�ti� � the penalry of perj�ay fhat the above and foregoing infomiation is true and oorred and tliat the a�ts was / were
lent of Ir�diana and owner of tlie akrementior�ed properi�, �n �� 1, 20
Person auttror¢ed by
w by IC 61.1-12-.07
exeuGed Power Of A�tOmey
oi aWhq�qed person