HomeMy WebLinkAboutMortgage_Angle�e�� .� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
a�; FOR DEDUCTION FROM ASSESSED VALUATION
� ... «. -! State Form 43709 (R6l 546)
Presvibed by Oepariment of Lorvl Gwemment Finance
INSTRUCTIONS:
Count Townshi Year
i
NOV 2 7 2006
File Mark
To be filed in pe�son or by mail with the CountyAuditor of the county where the propeRy is located.
Filing Dates: 1) Real Property: Dunng the 12 months before June Il of the year the deduction is to be eB
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and Ma�ch 2 of the �p��t�� ���B��flective.
See reverse srde for additional instructions and qualilications.
Applicant (o rorcontract bu�rer- see trictions on reverse si )
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Taxing Districl Key number / legal description Record number ,
n' i,�v7 03-0�• 3//'' yyo��a� GY��.
l�lJ�/�� �/�_' �p2c.�,- � Page number � ��
/ [/ /"
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, cunent year March 1, current year owneR ❑ Yes ❑ No
2. , ��
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diiferent than that of appticanf, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.1-�
�me of mortgagee or conirad seiler
Address of mortgagee or contrad seller (number and stieef, city, te, ZIP
Name of assignee or other owner or holder of mortgage ��
Address of assignee (number and street, crty, state, ZIP code) � �,�O,Y•^• •�'��
p�•a�ver 1
Does applicant own property in any other If yes, what county? Whal Taxing Di ........... •• � on
countyinlndiana? (�;11"C1 ��' "��� Spv ]No
�-Yph. � 'r3, �3
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COUNTY AUDITOR
Deduction approved in the amount of:
20 �� 20 �_ 20 O q 20 20 20 20
,
-P p
Signature Counry Auditor Date
�We certify under the penalty of peryury that the above and foregoing information is true and correcl and that the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
Signature ( n rs full name Person authorized by duly executed Power of Attomey
ar by IC 6-1.1-12-.07
Full resident a dress of plipnt Address of authorized person
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