HomeMy WebLinkAboutMortgage_McDanielSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSEO VALUATION Coun Township Year
�'• �«� I Siate Fortn o3709 (R514-03) `j,
Prescribed by Department of Local Govemmem Finance �\ �
� \�
INSTRUCTIONS: \\/ File Mark
To be filed in person or by mail with the County Auditor of fhe county where the property is located.
Fiiing Dates: 1) Reai Property: During the 12 monfhs before May 11 of the year the deduction is to be eflective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be ef/ective.
See reverse side for additional instructions and quali(cations.
ouyer-
Taxing Dislrid
Assessed value o(realproperty as of
March t, current year
If no, what is his / her exact share
resmcnons on reverse sfde) '
Key number / legal description
VV L � V
Mortgage / Contract ii
March 1, current year
name on record is different than thal of applicant,
mortgagee or contract seller
Address of mortgagee or conirad seller (number and
Name of assignee or
Address
owner or holder of mortgage
(number and street, city, state, ZIP
below:
. n •
e
Record number
. � Paqe number
unpaid as of Is the applicant the sole legal or equitable
ownef? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
state, ZIP
Does applicant own property in any other If yes, what county? What Taxing District?
county in Indiana?
Dedudion
20 � `�� � 20
Signature
COUNTY AUDITOR
the amount of:
�_ 20 Q� 20 20
p P
County Auditor
❑ Reai Prt�perty ❑ Mobile Home QC 61.
Has this deduclion been requesied on
property for wrrent year? [� Yes ❑ No
20
20
� We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
name)
of applicant
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Address of authorized person