HomeMy WebLinkAboutMortgage_Greer (3)�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-' ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
ti � Slale Fofm 43709 (R4/1D-01)
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Prescribed by DepaNrenl W Local Govemment Finante
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INSTRUCTIONS: � � E File M�
To be filed in erson or b mail with fhe Count Auditor ol the coun whe2 the ro e a
P Y y ty p p rty is loc .
Filing Dates: 1 J Real Property: During the 12 montAs be%ie May 11 0/ the year the deduction is to 6�@ ctive.
2) Mo6ile Homes assessed under IC 61.1-7: Behveen January 15 and March 31 of the d th���� is to be eHective.
See reverse side /or additional instructions and qualificaGons. /` , j� ��
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Applicant rorcont ct uyer-s e nc6onson2verse 'de) '��"' �'u� .* nuuu�� i
Taxing D rict Key number / legal description Rewr number O�
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtenl year March�rrent year owner? ❑ Yes ❑ No
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If no, what is his / her exad share of interest? ( owned with someone other than spouse, indicate with whom.
If name on record is difterent than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Horrie pC Cr1.1-�
�me of mortgagee or contract seller
Address ot mortgagee or conVad seller (number nd st2et, dty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applipnt own property in any other If yes, what wunty? What Tazing Distrid? Has this deduqion been requested on
county in Indiana? property for curtent yeaf? 0 Yes ❑ No
COUNTY AUDITOR
Deduc6on approved in the amount of:
/
20 �� 20 20 20 20 20 20 �_
P / Q �- � �v'� � P P
Signature County Auditor Date
We certify under the penaity of perjury that lhe above and foregoing infortnalion is true and corred and thal the applicants was ! were
esident of Indiana and owner of the aforementioned property on March 1, 20
ture ners /ull name) Person authorized by duty exewted Power of Attomey
' or by IC 6-1.1-12-.07
F ident ad ress of lipnt 7 �i/�� Address of authorized person
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