HomeMy WebLinkAboutMortgage_Luttrell (2)r.�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION
��� w� -y SWte Form 43709 (R6 / SO6)
Prescribed by Depariment of Lonl Govemment Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor of the county where the p�operty is locatG�.
Filing Dates: 1J Real Property: During the 12 months before ,lune �l o/the year the deduction is to be effecUve.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deducUon is to be effective.
See �everse side for additional instiuclions and qualifications.
or contract
��
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of
Key number / l-egal des�nplion Record number O
�lc-U� y�5�-,36�f-O�O. //"""�i��/5%Gb20 �p
O/ a/. �� / t/,�y �Q Page number � n n/ '
T / - /�f-
Mortgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, curtent year owne(? � Yes ❑ No
name on record is difierent ihan that of applicant, indicate betow:
mortgagee or contrad seller
Address of mortgagee or conVact seller (number and street,
Name of assignee or other owner or
Addre
mortgage
code)
ZIP
wilh someone other than spouse, indicate with whom.
❑ Real
'��;'t7
❑ Mobile Horrie (IC 61.
Does Dra�V�i �'�.Q" — S /a�/ wn �
ty. What Taxing Distrid? �' Has this dedudion been requested on
counl property for current yeaf? � Yes❑ No
�
C�1'Ci �'� . .....................
COUNTY AUDITOR
Dedudion approved in the amount ot:
20 • I 20 �_
vl � �
Signature
20�y 20 20
P
County Auditor
�
Date
20
We certify under the penaity oi perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20 ..
� -�
Full
X i
�/i ne
Person authorized by duly executed Power of Attomey
or by IC 6-t.t-12-.07
of authorized person