HomeMy WebLinkAboutMortgage_Mason (23)�F_�,<z STATEMENT OF MORTGAGE OR CONTRACT
a3� � INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
` VALUATION State Form 43709 (1-90) Prescribed by the
,���. State Board of Tax Commissioners
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Instructions for filing:
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.
ier or cont t buyer
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Taxing Dis ict '
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see restrictions on reverse)
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Key Number/Legal Description
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Year
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JAN 2 �� 1996 � � .
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Assessed value of real property as Mortgage/Contract Indebted�ess unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current ye equitable owner? O yes O no
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If no, what is his/her exact share or interest? If owned with someone
indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contract
Address of mortgagee or
of Assignee or other owner or holder of
Address of Assignee
Does applicant own !eal property I If yes, what county?
in any other county in Indiana?
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What Taxing District?
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
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Secretary of Board of Review
hler than spouse,
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Has this deduction been
requested on property for current
year? � yes ❑ no
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Date i
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I/We certify under penalty of perjury that the above and foregoing information is true and cor �ect and that the appli-
s was/were a resident of Indiana and owner of the aforementioned property on March 1,, 19
Sp atur,e (9,wners full name� Person authorized by duly executed Power of Attorney or
�'ln /I r/IIl %�;�n Nix �n �_� n. �'n n 1M ,�J�6-�.i-�z-.o��.
Address of Authorized Person
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