HomeMy WebLinkAboutMortgage_Warpenburg�
�i+
�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
SUte Fwm 43709 (RS / 4-03)
PresaiDed by Depanment of Local Govemment Finance
INSTRUCTIONS:
Coun Township Year
�������
AUG 1 �' 2�R�
Mark
To 6e filed.in person or by mail with the County Auditor of the county where the property is loo ta ed. ��
Filing Dates: 1) Real Property: During fhe 12 months before May 11 0/ the year the deductioriisto,�be evect �e.7r1 ��
2) Mobile Homes assessed under IC 6-L 1-7: Between January 15 and March?`o/the:yea�the�deduc6Qn_G�to�be effective.
See reverse side for additional instructions and qualifications.
Applicant (owner or contracf buyer- see iestrictions on reverse side)
l
Taxing Dislrict Key mber / legal description Re numbera � y_ 3"7 7�
Page number
Q / - ��a3a - �
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the�sole legal or equitable
March i, current year March 1, wrrent year � owne(? Q�Yes ❑ No
�J �� �
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
LyFleal PropeAy ❑ Mobile Home (IC 67.1-�
�me of moRgagee or contract seller
3
Address of moAgagee or contrad selier (number and st�eet, city, state, ZIP
Name of assignee or other owner or holder of mortgage '
Address of assignee (numberand strnet, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing Distrid? Has this deduction been requested on
county in Indiana? property for wrrent year?� Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 '�(� 20 � 20 O� 20 �� 20 20 � 20
P � P
Signature County Auditor Date
�� We certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the applicants was / were
sident of Indiana and owner of lhe aforementioned property on March 1, 20
Signa ure (owners full name) Person authorized by duly executed Power of Attorney
��� or by IC 6-1.1-12-.07
F I resident address of applicanl Address of authorized person