HomeMy WebLinkAboutMortgage_Rumble� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�. / State Fwm 43709 (RS / 6-03)
Prescn�etl by Department of Loral Govemment Finance
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�TRUCTIONS: Fn � � F Ie a
o be filed in person or by mail with the County Auditor of the county where the property is locaf�. ��
Filing Dates: 1) Real Property: During the 12 mon[hs 6efore May 11 of the year the deduction is to be ^��gr�tive� � 9oo�
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0( the year the deductlOn is to 6e effective.
See reverse side (or additional instructions and quali�cations. /� ��� n n
(owner o� contract buyer -
District
.
Assessed value of real property as of
March 1, curtent year
If no, what is his / her exact share of interest?
name on
side)
Key number / legal description Record number Q�
Q/� OQ% 3 3' l�l age number � ��
( YJ
Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, currentyearQ ` O owner? ❑ Yes ❑ No
U ��
If owned with someone other than spouse, indicate with whom.
than that of applicant, indicate below:
❑ Real Properiy ❑ Mobile Home (IC 61.1-7)
mortgagee or contrect seller �/�
of mortgagee or contrect seller (number and street, city, state, ZIP
or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant ovm property in any other If yes, what county? I What Taxing District? Has this deduction been requested on
county in Indiana? property for current year? ❑ Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 �� � 20 � � 20 t) 6 � 20
County Auditor
20 � I 20 �O `l
Date
20
I/ We certity under the penalty of perjury that the above and foregoing infortnation is true and correct and that the appliranis was ! were
a resident of Indiana and owner of the aforementioned property on March 1, 20
(owners (ull name)
\
Person aulhorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
person