HomeMy WebLinkAboutMortgage_Alexander.f�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
,..... - FOR DEDUCTION FROM ASSESSED VALUATION
Slale Form 43709 (RB I 2-07) l,
�° .- � Presoibed by Deparlment of Local Govemmenl Firiance
INSTRUCTIONS:
To be filed in person oi by mail with the County Auditor o/ fhe wunty where the property is bcated.
Fdinq Dates: 7J Real Property: Dunng the 72 months be/ore June 71 olthe year lhe deduction is to be e/%ctive.
2) Mobile Hanes assessed under IC 6-7.1-7: Behveen January 15 and March 2 0/ fhe year fhe deduction i�to be
See reverse side fw addifional instrucLons and qualilcations. U��
(owneiar
g Di Key number / I I esaiption ' lilo hf Er � F' ge rwmDer
7 �� -(�-o�-(ol - o00 . 4-9 S-c�� �a 3a
raiue of real propaty as af Mard� 1, aarenl y�r Monga9e I i e6tedness unpaid as of March 1, �s Ihe appticanl iha sde legal d equitade om�eR
anent ye ev�
��V ❑Yes ❑ No
whal is his / her e�cl share af interest? If owned with sorrieaie dher Ihan spouse, �cate wilh whom. �
If reme m record i5 Crtlereni Nan Nal W appl�canl, inaipte
Name ot mortgagee or conLact sdler
Address oF rtartgagee or cmlraC seller (number and streef I
Name of assignee or olher owner rn hdder of mortgage
Address of assignee (innnber a�M slreet dty. sfafe. arM ZiP
iicanl own praperty in a�ry alhef If yes. what counry?
Indianal
❑ Yes ❑ No
o� ��'� t�a 3�
— gcEx��'D ��,
ss GA�v'', �' G
COUNTY AUDITOR
20 20
c«,�n
Is ihe propeM in Questio�:
❑ Real Pmperty ❑ Mobile Hwne (IC 61.
s �his dedu�tion been requesled on property
artent yea(.+
❑ Yes ❑ No
20
,�
I I We certify under the penalry of perjury ma� me ew.� and foregoing infortnafion is We and correc[ and thal the applicanLS was / were a resident of
Indiana and owner of the aforementioned prope on March 1. 20
�,na4ue (owne/s IWI name) _. Date (monN, eay, year)
of
cay.
Permn aulhaizetl by duN ��� Power of NlaneY ��' IC 61.1-12-.07
Address af aultror¢ed persm (numberaiM sVeet, ci(y. sfafe, and ZIP oode)
'�'�.
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Date (rr�th, day. yea�