HomeMy WebLinkAboutMortgage_Hadley-�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Ye�
�'. �� / State Fortn 43709 (RS / 4-03)
PrascnEed by Department ol Local Govemment Finance �
�{ , a€' � ' �
TRUCTIONS: �'S q File M�
io be filed in person or by mail with the Counry Auditor of t6e county where the property is located. �L 3L
Filing Dates: 1) Real Property: During the 12 months before May 11 0l the year the deduction is to be e/fect(ya � �� 7Oj�3
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0( the year theNde�ucfi"on is90 7�e eHective.
See reverse sida for addifional instructions and qualifications. � �� n /)
Applicant
Taxing
orcontractbuyer-
�./ ��
Assessed value of real property as of
March 1, current year
I( no, what is his / her exact share of interest?
If name on record is diHerent than that of
of mortgagee or contract seller
nons nrevers@side)
' ,�(.�°.vt•A� InJ I� a-�,Q
Key number / legal description
� �a-DDbsy�
Mortgage / Contract indebtedness unpaid as
March 1, current year
.`l D, /)/J!/
of mortgagee or contract seller (number and
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state,
number
: number �� ��
Is the applicant the sole legal or equitable
owner? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
city, state. ZIP
Does applicant own property in any other I If yes, what counry? What Taxing District?
county in Indiana?
Deduction approved in the amount of:
20 20 20
Signature
COUNTY AUDITOR
20
Counry Audiror
20
�
property in questian:
❑ Real Property O Mobile Home pC E1.1
Has lhis deduction been requested on
property for curtent year? ❑ Yes ❑ No
20
�
20
I/ We certify under the penalty of perjury that the abave and foregoing infortnation is true and conect and that the applicants was / were
\resident of Indiana and owner of the aforementioned property on March 1, 20
address of
Person authorized by duly executed Power of Attomey
or by IC &1.1-12-.07
of authorized person