HomeMy WebLinkAboutMortgage_Hall.i� STATEMENT OF MORTGAGE OR CONTRACT INDE6TEDNESS
p' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�J, State Form 43709 (R6 / SO6) � � �
� Presmhed by Departmem of Local Govemment Finance
INSTRUCTIONS: File Mark
To be filed in pe�son or by mail with the CountyAuditor of the county where the p�operty is located. .
Filing Dates: 7) Real Property: During the 12 months 6efo2 June I1 0/ the year the deduction is to 6e ef(ective.
2J Mo6ile Homes assessed unde� IC 6-1.1-7: Between January 75 and March 2 o/the year fhe deducUon is to be eNective.
See reverse side fo� additional instiuctions and qualifications.
Applicant (ownero c ntract buyer- e restri s on reverse side)
.`
Taxing Disirid Key number / legal description Record number
� � �D 9 .3a � Isa-oi Page number �D�
Assessed va of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year owneR ❑ Yes' � No "
3 � �
Ii no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC 67.1-�
me of mortgagee or contraIX seller
Address of mortgagee or wntract seller (number d street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6c
Does applicant own property been requested on
county in Indiana? a G��_�� �� year?O Yes� No
Deduction approved in the : �.`f'"Q'a'a2 "r"'��`-'�
(���r�[.c-C�if� .CJ //'�-�C
20�_ 20 Q � ` /�'`� 20
� � c�,�e�." � ��� 2z8': S'd
Signature
� We certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the applicants was / were
esident of Indiana and owner of the aforementioned property on March t, 20
� Signature (owners (ull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
resi nl d ss of applicant Address of authonzed person
�