HomeMy WebLinkAboutMortgage_Osborn,�"•'< STATEMENT OF MORTGAGE OR CONTRACT
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INDEBTEDNESS FOR DEDUCTION FROM ASSESSED County Township Year
VALUATION State Form 43709 (1-90) Prescribed by the
' � State Board of Tax Commissioners
�
Instructions for filing: IIe�Mark
To be filed in person or by mail with the County Auditor of the county where the ��� �
property is located during the 12 months before May 11 of the year the deduction
is to be effective. See reverse for additional instructions and qualifications. N�� � t999
or contract
on reve�se)
Key Number/Legal Description
��9-aa75�-
G�Qso;s ��, � �
Record No.
No.
Assessed value f r al property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, curre ear as of M�-1, current year. equitable owner? O yes � no
�`0000
If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
AcJdress of mortgagee or contract seller
Name of Assignee or
of
er owner or holder of Mortgage.
Does applicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? ❑ yes � no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19_�,,_bQ�.. �!'.
�Sl�-i��nl �_
3
�a3�„�#`(�,�
_ Secretary of Board of Review
19 �
certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
waslwere a resident of Indiana and owner of the aforementioned property on March 1, 19
�ture (ow � full name) Person authorized by duly executed Power of Attorney or
�� ,�� / by IC 6-1.1-12-.07).
of Aplicant � Address o( Authorized Person