HomeMy WebLinkAboutMortgage_Byers (6)e`'�R�" � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
;. -~•. : FOR DEDUCTION fROM ASSESSED VALUATION
••,� �S' Slate Form 43709 (R4 ! 10-07j
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PrescnDed by Depanment ot Local GovemmeN Finance
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INS I KUG IIUNJ:
To be tled in person or by mail with the County Auditorol the counfy where the property is (ocafed. A�l1� 1 8 2004
Filing Dafes: 1) Real Property: During the 12 months be(ore May 71 0l the year the deduction is to be efletTb
2) Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0l the ar lhe deductio �s to be eNective.
See reverse side (or additional instructions and qualifrcations.
GI850N�C0t1 TY AUDITOR
(ownerorcontract buyer- see restrictions on reverse side)
Distrid
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Assessed value of real property as of
March 1, wrrent year
If no, what is his / her exact share of
Key number / legal description
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.ecord number
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Morfgage / Contract indebtedness unpaid as of Is the appiicant the;ole Iegal or equitat
March 1,•current year owner? �es ❑ No
� 7 DD�i
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate
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of mortgagee or coniract seller
Address of mor�agee or contract se
? �S F_ �1� i 1''� '
Name of assignee or other owner or
(number and street, city,
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mortgage
Address of assignee (number and street, city, state, ZIP cotle)
ZIP
Is the property in ques6on:
❑ Real PropeRy ❑ Mobile Home (IC &1.1
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, ��1_ aoo'1-3'7YR
Does applicant own property in any other I If yes, what counry? I What Taxing District? I Has this aeauction oeen reques�eo or
county in Indiana? property for current year?0 Yes� N
�edudion approved in the amount of:
20 20 � 7
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Signature
COUNTY AUDITOR
20 � 20 O 4 20
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Couniy Auditor
20
20
I I We certify under the penalty of perjury that the above and (oregoing information is true and corred and that the applicants was / were
a resident of indiana and owner of the aforementioned property on March 1, 20
name)
Full resident address ot apF
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Person authorized by duly exewtetl F'ower ot nttomey
or by IC 6-1.1-12-.07
of authorized person