HomeMy WebLinkAboutMortgage_Hill (2)i?�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'I\i•�r FOR DEDUCTION FROM ASSESSED VALUATION n hi Year
`:..,� Slate Form 43709 (R6 / 5-06) " - '
� Presaibed by Department of Local Gwemmen� Finance
INSTRUCTIONS: � F;�P f„iy�
To be filed in person or by mail with the CountyAuditor of the county where the property is located. ���
Filing Dates: i) Real PropeRy: During the 12 months before June 11 0/ the year the deductlon is to � e,((g�ti�NTY AUDITOR
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 o/thi �si�t�e eductlon is to be elfective.
See �everse srde for additional instructions and qualffications.
(owner or
Tauing
p .11.�-Ci �o- V.7 "J
ssessed value of real property as of
March 1, airtent year
If no, what is his / her exad
on
c
Key number / legal
-�.aga-�r
Mortgage / Contrad indebtedness
March 1, current year
If name on record is difterent fhan that of appticanf,
of mortgagee or contrad seller
Address ol mprtgagee or contrad seller
of aseignee or other owner or holder of
below:
Record number
Page number
unpaid as of Is the applicant the sole legal or equitable
owneR ❑ Yes ❑ No '
If owned with someone other than spouse, indicate with whom.
street, city. state, ZIP
Is the property in question:
❑ Real Property ❑ Mobile Hmie pC E1.
Atldress of asaignee (num6er and street, city, state, ZIP code) ,.
Does applieant own property in any other If yes Has this deduclion been requested on
county in Indiana? Dra�r�er N�, ,q�j ����� Property for curcent year? � Yes� No
Deduction approved in
20�_ 20
�
Signature
' Card NO. ......
� amount ot: `��✓I'1iI,lYR.�-�-*'� � SOj lJ�%� Ao
) 20 20 20
Y
County Auditor
20
Date
�
We certi nder lhe penalty of perjury that the above and foregoing information is true and coned and thal lhe applicants was / were
�eside of Indiana and owner of the aforementioned property on March 1, 20
In re(own rs Iull name) Person authorized by duly executed Power of Attomey
t //I �00.� _ _ �' /.e _'eA o� by ic s-i.�-iz-.o�
authorized person