HomeMy WebLinkAboutMortgage_Bonney+�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Yeai
�•> J State Fwm 43709 (R6 / 546)
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Prescnbed by Department of Local Govemment Finance
INSTRUCTIONS: il a �
To be filed in person or 6y mail with the County Auditor o/ the county where the propeRy is located. ��
Filing Dates: 1) Real Property: During the 12 months before June Il of the year the deduction is to be eHective. M,GY n 7�� ��
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduction 3 t�! tle'-ef�ecfive.
See reverse side for additional instructions and qual�cations. `�jj �,�
Applicant (o ne or contract 6uyer - see restri�ons on reverse side) """' `
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Taxing Disirict Key number / legat description Record nu r
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� Page number
a�- l�a- D4- . 53a-Da8 ���
Assessed value of real property as of ttgage-l-�Contract indebtedness unpaid as of Is the applicant the sole legal or c
March 1, current year March 1, curtent year owner? Q Yes. � No.
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If no, what is his / her exact share oi interest? If ovmed with someone other than spouse, indicate with whom.
name on record is different than that of applicant, indicate below: �
'e oP�_oRg�ee or_conVact seller
I,�(`.(JY��IZ �ANSVlL(...E IF�}CtiEr2S �'ilE?�f
ddress of mortgagee or contract seller (number and street, crty, state, ZIP
or oiher owner or
Does applfcant own
county in Indiana?
20 Q�
Signature
in any other � If yes, what county? � What Taxing District?
No
amount
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COUNTY AUDITOR
20 O 9 20 20
1
Counry Auditor
property in question:
al Property ❑ Mob�e Home QC 61.1-�
Has this deduction been requested on
property (or current year? Q YesO No
20
Da,e
20
certify under the penalty of perjury that the above and foregoing infortnation is We and cortect and that the appiicants was / were
lent of Indian and owner of the aforementioned property on March 1, 20
e'1� _ fylY!}im Person authorized by duly executed Power of Attomey
� or by IC 6-1.1-12-.07
C
;i ent a dress of appi�cant n Address of authorized person
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