HomeMy WebLinkAboutMortgage_Sartore (4)i�^+n
t STATEMENT OF MORTGAGE OR CONTRACT INDEBI'EDNESS
'i: �; FOR DEDUCTION FROM ASSESSED VALUATION
. J Siale Fwm 43709 (R6 / 5-06)
�� Presrnbed by Departmenl of Lopl Govemment Finance
n hi Year
I
I
JUN 0 4 2007
INSTRUCTIONS: File Maric
To 6e (iled in person o� by mail wrth the County Auditor of the county where the p�operty is located. `�
Filing Dates: 1) Real P�operty: Dunng the 12 months befo2 ,lune t 1 0/ the yea� the deduction is to be dli�C �'a �
2) Mobile Homes assessed unde� lC 6-1. iJ: Between January 15 and Maroh 2 of �gg�gQ �B��ctlqyrj�(�¢e eSective. /"�)
See �everse side for additional instn�ctions and quali/ications. O�0�"
�Qq °
Applicant (owner ot contract buyer- see
,;G��.�� �:, �J
Taxing Dislrid
�i ),/u--� �����
Assessed value of real property as of
March 1, curtent year
If no, what is his / her exad share of interest?
If name on record is
on reverse side)
53 3 a�ssa y
Key number / legal description Record number
am.os_ov_ oo?-�o�.a8oi8
�`�o� � �Ja7Qv Pagenumber
Mortgage / Contrad indebtedness unpaid as of Is the ap i�
March 1, current year ownef?
� ���
than that of appticanf, indicate bstow:
of mortgagee or contract seller
1 tFie sole legal or equitable
❑ Yes ❑ No
If owned with someone other lhan spouse, indicate with whom.
Is the property in
❑ Real Property( l�Mo�ile Home (IC 6�1.
Address of mortgagee or c�nJrad seller (number and street, city, state, ZIP
of a�ignee or other owner or holder of mortgage
and street, city, state, ZIP code)
Does applicant own property in any other If yes,
counry in Indiana?
20.0_7
Signature
the amount of:
� ��
) -�— ��1 ( 20
�f po}
C�'p _k��
�
counry? What Taxing Distrid? Has this deduction been requested on
property for wrtenl year7 � Yes ❑ No
COUNTY AUDITOR
� 20 20
�
_ County Auditor
20
Date
�
We certify under the penalty of perjury thal the above and foregoing information is true and correct and that lhe applicants was / were
resident of Indiana and owner of the aforementioned propeAy on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person