HomeMy WebLinkAboutMortgage_Breidenbaugh.a ^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
FOR DEDUCTION FROM ASSESSED VALUATION
State F«m 43709 (R81 2-07)
�� y�� 1 PresrnbeE by Depahmml W Local Govemmenl Finance
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INS7RUCTIONS:
To 6e �led in person or by mad wRh the CountyAuditor ol the county where the properly is located.
Fding Dates: i) Real Property: DuAng the 12 rtronths be/we June 11 0! the year tlre deduction is to be etiective.
2) Mobiie Hames assessed under IC 6-1. 7-7: Behveen January 15 and March 2 of fhe year fhe deduction i{� Qe �9�ti� � 8
See 2verse side for addifional instrucfions artd qualifications.
Appimr�l(owner ar - see � stl •
A DITOR
'stricl � ��� /V/� ��n �L/ � �.-�V � � K/. T �O-� —V R� P�'O
vdue of real pmpeny as d Maich 1, aarent yzar Mor�qag�,y6ontrad indebtedness unpaid as of March 1, �s ihe appticant Ihe sde legal w equi�aWe ame(1
wrtenta� / � A � �� ❑Yes ❑ No
�r `TY ) t � ( 1
his / her ezact share
applicanl iMiple below:
seiler
Address of mortgagee ar conUad seller (number arM s[reef. tity, state, ard ZIP
Nartre of assgrree a Wx.r o.vner or holtler W mortgag
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Wlal Taxing Disiricll
AUDITOR
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Is Ihe properly in question:
❑ Real Rnperty ❑ Mobile Home (IC 6
Has Ihis tl�
for arrrnt
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uested on poperry
❑ Yes ❑ No
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I I We certi�y under the alry oi perjury at the abrne and foregoing in(ortnation is true and mrrect and that the applitanfs was / were a resident o(
Indiana and owner ot e afwementioned ropeAy on March 7, 20 '
�nawre (mvners nd� name) oate (mmm. ear. r��)
Q `-�,�_{� r�.�nbou�4�
ddenladtlressotapplicanl(numberandstreeLcdy.stafe,a ZIP e)
t—W u W• C� lQ.r'�p�.Ci�P S• Cl I � C�'-�"CYl , 1 �l —1_�
�Wtror¢ed by Euy ezewted Power of Attwnay w by IC G7.1-12-.07 Oale (monN, tlaY Y��)
Address of aWtn¢ed pason (n�mbeiaMsLeet cdy, sfate, arW LP code)