HomeMy WebLinkAboutMortgage_Wilkison�E,pa, STATEMENT OF MORTGAGE OR CONTRACT
a�a:� "; INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
��' VALUATION State Form 43709 (1-90) Prescribed by the
�� ,
e• State Board of Tax Commissioners
Filinq f.se $1.00
� , File Mark � '
Instructions for filing: � � �
To be filed in person or by mail with the County Auditor of the county where the '
property is located during the 12 months before May 11 of the year the deduction ,
is to be ecti . SeeLev�rse f rc� ,�ddilionalynstructions and qualifications. ���!��
�� G: W �.kJl'uAo-. asl
�. q_��_o►_ �t 23 1998
Applic (Owner or cont t buyer - e restrictions on reverse) �
� � „/ � �C, .-/`l�u,,, , .r.,�
T ing District Key Nu�p er/Legal Description cDFd No�"`"'� ��' "�� '
�,� �_ Ot`X - bosal- oa . .
i ��� 4/� — O YY —o Page No.
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of N�arch 1, current year. � equitable owner? � yes ❑ no
If no, what is his/her exact share or interest?
If owned with someone other than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
mortgagee or contract
Address of mortgagee or contract seller
Name of Assignee or other owner or holder
Address of Assignee
e.
Does applicant own real property If yes, what counfy? What Taxin� District? Has this deduction been
in any other county in Indiana? requested on property for current
year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
' ��i� � . -
Signature
�
I�'� •lf�'��'/S!1��i7Q�v
of Board �f Review .. Date
- - ( —(o��''!�
�S- ¢oo
�
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
_'s was/were a resident of Indiana and owner of the aforementioned property on March t, 19
Signature (owners full name) , Person authorized by duly executed Power of Attorney or
��� �.. ,� t,'� a�.. by IC 6-1.1-12-.07).
Resident Address of Aplicant Address of Authorized Person
, f�..�, 3��8 On��.�,_.�._ u-►r�c��,