HomeMy WebLinkAboutMortgage_Hill`°�'"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'. � FOR DEDUCTION FROM ASSESSED VALUATION
S J Stale Form 43709 (R4 / 10-01)
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� PrescribeA by DeDartmenl of Local Govemment Finance
INSTRUCTIONS:
�o oe tned m person or by mail wlfh the Gounty Audifor of the county whe2 the property is located. r,�s,v
Filing Dates: 1) Real Property: During the 12 months beloie May 11 of fhe year the deduction is to 6q esrectiveR POO2
2) Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0/ the year the ded tion is to b effective.
See reverse side /or additional instructions and quali�cations. �
t;iRSON COU TY FUDITOR
Applicanl (ow r or contrdct b yer- see res ' tions on reverse side) �
Taxing Distrid Key number / legal description Record number �
� QO � O �Q� B,� Pagenumber �� ^
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Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March 1, wrtent year �[� ��� owneR ❑ Yes ❑ No
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If no, what is his / her exact share of inlerest? If owned with someone other than spouse, indicate with whom.
If name on record is different lhan thal of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Horne (IC 61.1-�
e of mortgagee or contracl seller �
Address of mortgagee or contrad seller (number and treet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxi istri ? Has this dedudion been requested on
county in Indiana? property for current year? � Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
oy
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Signalure County Auditor Date
We ceAify under the penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
.sident of Indiana and owner of the aforementioned property on March 1, 20
igna ners full name) Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
F I sident address of applicant Address of authorized person