HomeMy WebLinkAboutMortgage_Russell (3)�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�+ w� ! State Fwm 43709 (R5 / 4-03) . . : ' , .. , . . .
� PresaiDed by Department of Local Guvemment Finance '
INSTRUCTIONS:
To be filed in person or by mail with lhe County Auditor of the county where the property is located.
Filing Dates: j Real Property: During the 12 months belore May 11 of the year the deduction is to be ef/ect��t��Y � 9 2��6
2 Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 oI the year the deduction is o be eNective.
See reverse side Ior additional instructions and qualifications. �-y,la� ��
O'
0
(owner or
Taxing Dislrict
on
Key numb�// legal
l- aQ Q.,
Asses e alue of real property as of MoAgage / ContraIX ii
March t, wrrent year March 1, current year
�
If no, what is his / her exact share of interesl?
If name on record is diHereni than that of applicanf, indicate below:
of moAgagee or contraIX seller
Address ot mortgagee or coNract seller (number and st2et,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st�eet, city, state, Z1P code)
Dces applicant own property in any other I If yes, what county?
county in Indiana?
Deduction approved in the amounl
20
Signature
20
OIqOON
Record number
� _Q/q Page number
V O
unpaid as of Is the appli nt the sole legal or
owneR ❑ Yes ❑ No
Q Q'V
If owned with someone other than spouse, indicate with whom.
ZIP
What Taxing District?
COUNTY AUDITOR
20 0 q 20 20
P
County Auditor
Is the property in question:
O Real Property ❑ Mobile Hane (IC 61.
��♦� • • �
Has lhis dedudion been requested on
property for current year? � Yes � No
20
Date
�
' We certify under the penalty of peryury that the above and foregoing information is true and corred and that the applicants was / were
residenl of Indiana and owner of the aforementioned propeAy on March 1, 20
3nat e ners full/rqme�� A Per � n authorized by duty executed Power of Attomey
G �i Lfj or b IC 6-1.1-12-.07
of authorized person