HomeMy WebLinkAboutMortgage_Mays�i � STATEMENT OFMORTGAGE OR CONTRACTINUEBTEDNESS
`i' •':' �= FOR DEDUCTION FROM ASSESSED VALUATION , 'Count T sh� r
J State Form 43709 (R6 / 5-06)
J
� Prespibed by Department of Lopl Govemment Finance
INSTRUCTIONS: � Ma ��
To be filed in pe�son or by mail with the County Auditor of the county. where the property is located. °`�.
Filing Dates: i) Real Property: During the 12 months 6efore ,lune �l of the year the deduction is to be effefdfB£ON COUNTY AUoIT
2J Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be efiec��.
See reverse side for additional instructions and qualifications. -
�
(owner or
Taxing Distrid
Assessed value ofree
March t, wrrent year
see restrictions pn rtroverse side)
Key numtier /
- - I Record number ,.,
�
� a(o —O rj-d l- 200 - 000.0�0 -o i7 Page number I,���
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as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the soie legal or equitable
March 1, current year . � ' ownef? �d%s ❑ No
0a����. �l)
if no, what is his / her exad share
If name on record is diiferent than that of applicant, indicate
mortgagee or contrad seller
Address of mortgagee or
1 .� l
(number
Name of essignee or other owner or holder of moi
AddresS
(numberand street, city, stat
Does applicant own property in any other If yes, w,
county in Indiana?
Uetluction approved
20 �
1
SignaWre
in the amount of:
20 0 20
P
If owned with someone other lhan spouse, indicate with whom.
1_
� C�fFeal Property O Mobile Home QC 61.1-�
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County Auditor
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20
ceAify under lhe penalty of perjury that the above and foregoing information is true and correc[ and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
ire (owners lull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
applicant
ofauthorized person