HomeMy WebLinkAboutMortgage_Muncy (5)`°R�'�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION P Year
Count Townshi
S y S�ate Form 43709 (Ra ! 70-0t )
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� PrescribeA Dy Oepanment ot Local Govemmem Finance
INSTRUCTIONS: � � File �v[� �
To be filed in person or by mail with the County Auditor of the county whe�e the property is focated. � 1LJ
Filing Dates: f) Real Property: Dunng the 72 monfhs belore May 11 0/ the year the deduction is to be effective. . rt
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0/ the year fhB dealuctio�n �vi��e ef/ective.
Jee reverse sltle Ior additional instructions and qualifications. �
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Applicanl (owner or contract buyer- see restnctions on reverse side) � -""'""' ��" "- -
Taxing Distrid Key number / legal description Record number
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Assessed value of real pr erty as of Mortgage / Conlracl indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year ownef? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in queslion:
❑ Real Property ❑ Mobile Home QC 61.1-�
�e of mortgagee or contract seller
Address of mortgagee or contrad seller (number and stieet, city, state, ZIP
Name of assignee or other owner or holder ot mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what counry? What Taxing Distrid? Has this deduction been requested on
county in Indiana? property for wrrent year? � Yes❑ No
COUNTY AUDITOR
Deduction approved in the amounl of:
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20 ��' 20 � 20 0 20 20 20 �� 20 �� �
5 ���3 � P P
Signa ure County Auditor Date
e certify under the penalty of perjury that the above and foregoing information is true and corred and that ihe applicants was / were
ident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person authorized by duly executed Power of Attomey
�� or by IC 6-1.1-12-.07
F 1 resident address of a licant Address of authorized person
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