HomeMy WebLinkAboutMortgage_Lungs°'� STAIEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
� ' Slate Form 43709 (RB / 2-07)
�� 1 pr�rn'bed by Depanment ot Local Govertmenl Firmnce
ww
File Mark
INSTRUC710NS: �"
To be filed in person w by mad with the CountyAuditoi o/ the county where the property is located. �� �j �
Fding Dates: 1) Real Property: Dunng the 72 months before June 11 of the year the deducfion is to be eRective. 8'
2) Mobile Homes assessed under IC 67.7-7: Behveen January 15 and March 2 o7fhe year fhe deduction is fo v�--�
See reverse side (a addifional insWctions aiM quaGficafions. • .
ApplKant (owner nvau Duier - see resvc ros on �everse
Oi "cl Ke rnimber/lagaldesc
s
I
AQassetl value of � PW�Y as of Mard� 1, ament year � h4
ai
�'�- what is his / har ezacl share W intemsl?
�
If reme on record is difterent than lhat of applican4 ��iote bel
Name of morlga9ee or canUaG seller
Adtlress of moM1gagee w amlraG seller (numbu and t. r�
`
Name af asvanee or oUier owner or hdder ot mariqa_ e
Addressofassgnee(num6erands6eeL�
Dces aQplicenl own poperty in arry olher
county in Indiariaa
❑ Yes ❑ No
Deduction apprwed in the amount of:
� � �
SianaW re af CaunN �dbr
mde)
� . � GI SON � y DI �
Contract indeWedness unpaid as of March 1, Is Ihe appti�anl Ure sde legal w equitade wvneY?
� ❑Yes ❑No
If owned with someone olher �han spouse, indicale with wlwm.
�u�G, Ct+ssta P���-
D�-d►3�
Is Ihe property in ques�on:
❑ Real Pfpperty ❑ Mobile Hwne QC 61.
Has ihis dedudion bcen
ro. �„Rem yean
20
.restetl on properry
❑ Yes ❑ No
Dale (�N. day, yea�
�
1/ We certify under the penalty of perjury that ihe above and forcgoing infwmatan is We and corted and thal fhe applicants was / were a resident of
Indiana and owner oi the afwemenfioned property on March 1, 20 /
�na4ue (mme/s 1 rertw) � Date (month. daY. Y��1
`sidenl adtlress of applicanl ( umber and sheel. y. state, a 1 e) � /� /� /
ri/JS /i �. /j1 /� i /l� r �91n�'� . �/ i ` (i N�
ailhonzed by duN exeated Porier of lLLinmey or IC Gi.i-12-.07 / ' " Date (rtanN. day, yea^
ot aNhoraed persa� (number aM sLeef, dty, stafe, aM LP code)