HomeMy WebLinkAboutMortgage_Townsend (3)`��° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES
zi�� FOR DEDUCTION FROM ASSESSED VALUATION a ownship Year
��, i State Fortn 43709 (R6 / 5-06) ��L 0 5 2001
Presaibetl by Depariment of Local Govemment Finance
INSTRUCTIONS: �„ UNTY�H �
To be filed in person oi by mail with the County Auditor ot the county where the property is /oca�SON COU
Filing Dates: 1) Real Property: Dunng the 12 months befoie June 11 0( the year the deduction is to be eNective. �
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and Ma�ch 2 of the year the deduction is to be eltective.
See reverse side for additional instructions and qualifications.
contract buyer- see restrictions on rever e side)
r-/. . 9� � /a-,.��
Taxing District
Assessed value o( real property as of
March 1, current year
no, what is his / her exact share of interest?
Key number / Iegai description
-17-�aJ- aa3-000.la� y-o a
Record number
number
Mortgage / ConlraU indebtedness unpaid as of Is the applicant tfie sole legal or
March t,�urent year ownef? ❑ Yes ❑ No
I•/ I
name on record is difterent than that of applicant, indicate below:
fine of mortgagee or contract seller �
� ��
ddress of mortgagee or conirad seller (number and stree 'ty, s
ame ot assignee or other owner or holder of mortgage
(number and st2et, city, state, ZIP code)
Dces applipnt rnvn property in any other I If yes, what county?
county in Indiana?
Dedudion
20 ��
�
Signature
the amount ot:
Ii owned with someone other than spouse; indicate with whom.
❑ Real Properry ❑ Mobile Hane pC 61.
VJhat Taxing Distrid? Has this deduction been requested on
property for wrrenl year? 0 Yes � No
COUNTY AUDITOR
v��:�„����.o.a. U.o.?:3Fss�
20
20
20
Card NO. ...... ` I
,c Q p V .
We certify undei �n-Q,C� w/�� d UU• } iformation is true and corred and that ihe applicants was / were
resident of Indiar._ _..,Y ..��� ui ine�tioned property on March 1, 20
full
Person authorized by duly executed Power of Attomey
ar by IC 6-1.1-12-.07
res�aent aaaress or appucant IAddress of authorized person
po B v� ��� (�,,. a..f�J1. �tV .