HomeMy WebLinkAboutMortgage_Bonaparte (2)�e�.� "RA� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION Cyyou��nt
/ State Form 43709 (R6 / 5-06) � �
Presaibed by Depariment of Local Govemment Finance
� .
INSTRUCTIONS: �iR �i1Q��T�,
To be filed in pe�son o� by mail with the County Auditor o/ the county where the property is locafed. ��
Filing Dates: 1J Real Property: During the 12 months 6e/ore ,lune �f oI the yea� the deduction is to be eflec�� �
2J Mo6ile Homes assessed under IC 6-1.1J: Between January 15 and March 2 o/the y�aCSON Copyuon��s be el/ective.
See reverse srde fo� additional instructions and qual�cations. �a W NTY AUDITOR
see restridions on r�verse side)
Taxing
Assessed value of real properry as of
March t, current year
If no, what is his / her exad
Key number / legal
Mortgage / Contrad ii
March 1,.current year
name on record is different than ihat of applicant,
of moRgagee or canVad seller
Address of mortgagee or conVad seller (number
Name of assiqnee or other owner or holder of
assignee (numberand street, city, state,
Does applicant own property in any other I If yes, what �
counry in Indiana?
approved in the amount of:
20 � 20 � q 20
r� P
Record number
Page number
as of I Is the applicant the sole legal or equitable
owne(? ❑ Yes ❑ No
If owned wilh someone other than spouse, indicate with whom.
1
city, state, ZIP
*� �8- /3�7
9 t�.�� �
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COUNTY AUDITOR
20 I 20
s the property in question:
❑ Real Property ❑ Mobile Home QC G1.1-�
Has this deduction been requested on
property for current yeaR � Yes ❑ No
20
20
Signature County Auditor Date
' We certify under the penalty of perjury thal the above and fore ng information is true and corred and that the applicants was / were
;siy�ept of Indiana and owner of the aforementioned prope on March 1, 20
/ull
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Fuil r�sident address of applidaN � � �_ �� �Address of authonzed person