HomeMy WebLinkAboutMortgage_Alldredge�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
� � FOR DEDUCTION FROM ASSESSED VALUATION
S � State Fortn 43709 (R4 / 10-01)
w.
� Presqibe0 by Departmenl W Latal Govemment Finance
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor o/ the county where the property is locatetl.
Filing Dates: 1) Real Property: Dunng the 12 months be%re May 11 0l the year the deduction is to be efle4�� Q'] 200�
2) Mobile Homes assessed under IC 6-1.1-7: Belween January 15 and March 31 0( the year the deduction is be eHective.
See reverse side (or additional instructions and qualifica6ons. � `/ � n n
Applicant (owner or contiact
Distrid
.
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share
restrictions on reverse side)
number / legal description
Ul`� ^ UlX)oL l ^
Mortgage / Contrad indebtedness
March 1, wrrent year �/ F7D
/ �>
on record is different than ihat of applicant, indicate below:
of mortgagee or conVact seller
A� C� n �
GI3SON C°OUF!7 v
as of I Is the applipnt he sole legal or equitable
ownef? s ❑ No
If owned with someone other than spouse, indicate with whom.
Address of mortg�pee or conVad seller (number and street, aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and st�eet, city, state, ZIP code)
Does applicant own propeRy in any other If yes, what county? What Tauing Distrid?
county in Indiana?
approved in the amount of:
20 Q�_ I 20 �',� I 20
COUNTY AUDITOR
r � / �i
the
� Mobile Hame QC 61
Has this deduclion been requested on
property for current yea(? 0 Yes ❑ No
20
8� 1 � �
Signalure ?o0 9 Counry Auddor Date
�
I/ We certify under the penalty of perjury that the above and foregoing infortnation is lrue and correct and that the applicants was / were
1i resident of Indiana and owner of lhe aforementioned property on March 1, 20
of Attomey
or by IC 6-1.1-12-.07
�ident address of applicant ' Address of authorized person
5,�7 w, a,�K sr i���N«�,� �