HomeMy WebLinkAboutMortgage_Williams (15)`°�""° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
i-" .� FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
�, �> StalO Form 43709 (R4 / 70-01) �
u.
� Prescribed by Department of Local Govemment Finance
INSTRUCTIONS: � gFitrMa�
To be filed in person or 6y mail wilh the County Audilor ol the county whe2 the property is located. d
Filing Dates: 1) Real Property: Dunng the 12 months belore May 11 0/ lhe year the deduction is to be e ective:�
2) Mobile Homes assessed under !C 6-1 J-7: Behveen January 15 and March 31 0/ the year the dedy�tion is to be e tive.
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See �everse side (or additional instructions and quafi�cafions. � Z�QZ
Applicant (owne� or contract buyer
Taxing District �
��
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of interest?
side)
Key number / legal
�
O�c, _QQ 0�,� \ Pagenumber � �
a �
MoAgage / Contracl indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year ownef? ❑ Yes ❑ No
'��044
If owned with someone olher than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
of mortgagee or contrad seller
Address of mortgagee or contract seller (number and
Name of assignee or other owner or hoider of moAgage
C%ty,
Address of assignee (number and street, ciry. state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing District?
county in Indiana?
Deduction approved in the amount of:
20 /L2 /�// I 20
COUNTY AUDITOR
) O 20 20
�
County Auditor
s the properiy
❑ Real PropeAy ❑ Mobile Home (IC 61.1
6 �/-
Has this deduction been requested on
property for curcent yeaf.� � Yes ❑ No
20
r � �li � .
. �
certify under the penalty of perjury lhat the above and foregoing information is true and corred and lhat the applicants was / were
lent of Indiana and owner of the aforementioned propeRy on March 1, 20
Person authorized by duly executed
or by IC 6-1.1-12-.07
person