HomeMy WebLinkAboutMortgage_Bathgates�°�a STATEMENT OF MORTGAGE OR CONTRACT
��f"^:� `; INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
�� `. State Board of Tax Commissioners
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Instructions for filing:
To be filed in person or by mail with the County Auditor of the county where the
property is located during the 12 months before May 11 of the year the deduction
is to be effective. See reverse for additional instruc ions and qualifications.
Filin fee $1.00
County Township Year
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�pp�nt (Ovyner or cQnuac��uyer - see.�esf tions on rey.�rse) �
Taxing District
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�mObti � ey,�l D�sc�iption
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No. �� 0 ,
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Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the s e legal or
of March 1, current year as of March 1, current year. equitable owner? yes ❑ no
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If no, what is his/her exact share or interesi? If owned with someone other than spouse,
indicate with whom. , „
If name on record is different than that of applicant, indicate below:
of mortgagee or
Address of mortgagee or contract
ame of Assignee or other owner or holder of Mortgage.
Address of Assignee
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Does applicant own real property If yes, what county. What Taxing District. Has this deduction been
0 0
in any other county in Indiana? requested on property for current
year? O yes ❑ no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
19��_�''JS 19 ib' 19��
Signature
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ry of Board of Review
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I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
���waslwere a resident of Indiana and owner of the aforementioned property on March 1, 19 .
ture (owners full name) Person authorized by duiy executed Power of Attorney or
�� .. n �. , :� by IC 6-1.1-12-.07).
r�u Resident A4idress of Aplicant Address of Authorized Person
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