HomeMy WebLinkAboutMortgage_Robb�`° ��'�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
S�J State Form 43709 (R4/ 10-07)
� �.
Prescribe0 by Department of Loral Govemment Finance
INSTRUCTIONS: -T Tle Mark
To be filed in person or by mail with the County Auditor o! the county whe2 the property is locatetl ��� `4 � �
Filing Dates: 1) Real PropeRy: Dunng the 12 months 6e7ore May 11 of the year the deduction is�to 6e eKective� "J
2) Mobile Homes assessed under IC 6-1. 7-7: Behveen January 15 and March 31 0( the year the de��duqu�is to be e!/ective.
FEB U �
See reverse side (or additional instructions and qualificafions. „ _ �
buyer-
Taxing
���
Assessed va of real property as of
March 1, current year .
If no, what is his / her exact share of
G13SOP1
Key number / legal description � Record number
� �' QD ��/ �D � Page number � /� ^
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Morlgage / Contracl indebtedness unpaid as of Is the applicant the sole legal or
March 1, wrrent year ownef? ❑ Yes ❑ No
'15, I 9 � . o0
If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
�e of mortgagee or contract seller ����
Address of mortgagee or contrad seller (number an treet, city, state, ZIP
assignee or other owner or hoider of mortgage
of assignee (number and sfreet, city, state, ZIP code)
Does appliwnt own property in any other If yes, what wunry? I What Taxing District?
county in Indiana?
Deduction approved in the amount of:
20�`���� 20 03 � 20
�s
COUNTY AUDITOR
�
County Auditor
❑ Modle Hane (IC Crt.
Has this deduction been requested on
property for current year?0 Yes❑ No
20 %/ (O 20 I
�
Date
20 Q�_
P
ify under the penalty of peryury that the above and foregoing information is true and corred and that the applicants was / were
of Indiana and owner of the aforemenlioned property on March 1, 20
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
address of applicant , „ �Address of authorized person