HomeMy WebLinkAboutMortgage_Barton (2)`°rt'° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-' ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. � � � State Form a3709 (R4 / 10-01) � � �
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� Prescribe0 by DeDartment ol Local Ga�emment Finance
INSTRUCTIONS: '�AN Fle Nfar�CO3
To be 61ed in person or by mail with the County Auditor o/ the county whe�e the praperty is located.
Filing Dates: 1) Real PropeRy: During the 12 monfhs be%�e May 11 of the year fhe deduction is to b eHectiv �
2) Mobile Homes assessed under IC 61.1-7: Behveen January 15 and March 31 0/ th��i �7� Y i� t�� e ective.
See reverse side �or additional instructions and qualifications.
Applicant ( erorcont ct buyer- s�ns n reverse 'de)
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Taxing Di d Key ber legal description Record number
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, currenl yearG,1�� owneR ❑ Yes ❑ No
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Ii no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is dif(erent than that of applicant, indicate below: Is the property in queslion:
❑ Real Property ❑ Mobile Home QC 61.1-�
�ime of moRgagee or conVaIX seller ,
Address of mortgagee or contrad sel number st2 , city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applipnt own property in any other If yes, what counry? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for cunent yeaRO YesO No
COUNTY AUDITOR
Deduction approved in the amount of:
zo Q�_ zo o� Zo o.r Zo zo � zo 04 zo 0 9
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Signature County Auditor Date
��/ We certify under the penalty of perjury thal the above and foregoing infortnation is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signatur owners ll name) Person authorized by duly executed Power of Attorney
x or by IC 6-1.1-12-.07
F 11 resident addr of applipnt %� Address of authorized person
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