HomeMy WebLinkAboutMortgage_Bowen� rt�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
r--_ : FOR DEDUCTION FROM ASSESSED VALUATION
'> f State Form a3709 (R I 12-99)
uu
� PrescnDed by State Board of Ta�c Commissioners
InsVuctions for filing:
To be filed in person or by mail with the County Auditor of the counfy where the property is
located during the 12 months before May 11 of the year the dedudion is to be effective. See
reverse side for additional instructions and qualifications.
Taxing
orcontract 6uyer- see restrictions on reverse
FORM 5
FEB L 2001
number / legal desuiption � Record number
� Page number
c� q- � b p 31�1J�
Assessed value of real property as of Mortgage / Contract ihdebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March t, current year owneR ❑ Yes ❑ No
If no, what is his / her exact share ot interest? if owned with someone other than spouse, indicate with whom.
If name on record is different than [hat of applicant, indicate below:
of mortgagee or contract seller
of mortgagee or contract seller (number and street, city, state, ZIP
of assignee or other owner or holder of mortgage
�s of assignee (number and st2et, city, state, ZIP code)
Does applicant own real property in any If yes, what county? What Taxing Districl? Has this deduclion been requested on
olher county in Indiana? property for current yea�? ❑ Yes❑ No
PROPERTY TAX ASSESSMENT BOARD OF APPEALS
Deduction approved in the amount
20 Di� I 20n7, 1.\� I 20
(,�13��1� ��� ��
20 6� I 201j,�
�� 09 Secretary of PTABOA
� P
r� / �
Date
20
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/ We ceAify under the penalty of perjury Ihat lhe above and foregoing information is true and correcl and that the applicants was / were
i resident of Indiana and owner of the aforementioned property on March 1, 20
address of applicant
�i/7 E. X,F.•iTc e �«, S
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
y�[ �e IAddress of authorized person