HomeMy WebLinkAboutMortgage_Stewarta��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
" FOR DEDUCTION FROM ASSESSED VALUATION Cougn Township Year
y State Form 43709 (R6 / 5-OG) ��
� Presaibed by Deperiment of Lotal Gwemment Finarxe
wsrRUCnoNS: APR 2 3 2�9e Mark
To be frled in person or by mail with lhe County Auditor o/ the county whe�e the propeRy is located.
Filing Dates: 1) Real Property: During the 12 months belore June Il of the year lhe deduction is to b �
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 QIBSONa� �'B��o be eRective.
See �everse side for additional insWcGons and qualificaGons.
Applicant (ow er or cont2 t buyer - see stnctions on reverse side)
� `P�wY,�. cr �
axing District Key number I legal description Record number
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Page number
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Assessed vatue of real property as oi Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owner? � Yes � No
S �Ol
If no, what is his / her exact share oi interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that oi applican indicate below: Is the properly in questlon:
❑ Real Property 0 Mobile Home QC 61.1-7)
��e of mortgagee or contract seller
Address of mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, cify, state, ZIP code) �
Does appliqnt own property in any other If yes, what county? What Taxing District? Has this deducdon been requested on
county in Indiana? property for wrrent year? ❑ Yes❑ No
� a _� _� 7� COUNTY AUDITOR
Deduction approved in the amount of:
�
20 O 20 _� 20 �9 20 20 20 20
P � P
Signature County Auditor Date
I I We certify under the penalty of perjury that the above and foregoing infortnation is true and correct and that the applicants was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20
��yna owne s lulG �e) Person authorized by duly executed Power of Attomey
. `1� or by IC 6-1.1-12-.07
FuCe dent address of applicant Address oi authorized person
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