HomeMy WebLinkAboutMortgage_Chavis.. °�4 STATEMENT OF MORTGAGE OR CONTRACT
a�?:� ` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
��.' VALUATION State Form 43709 (1-90) Prescribed by the
State Board of Tax Commissioners
Filin fee $1.00
County Township Year
95
Instructions for filing:
To be fiied in person or by mail with the County Auditor of the county where the
property is located during the 12 months before May 11 of the year the deduction �
is to be effective. See reverse for additional instructions and qualifications.
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?�PR � 7 T985
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A i nt (Owner Rr c r ct bu er - see restrictions on reverse) AUDITOR °
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T istrict Key Number/Legal Description Record No. _
� ol9-oy�.y
S � Page No.
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as of March 1, current year. equitable owner? O yes � no
�^ �
If no, what is his/her exact share or interest? If owned with someone oiher than spouse,
indicate with whom.
If name on record is different than that of applicant, indicate below:
�e of mortgagee or contract seller �
Address of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee
Does appiicant own real property If yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? ❑ yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
�s9�L 19 �''!� 19�Oa 19 19�% 1$�bZZ'�$
`. a s- a i B _' oA�_
Signature S cre ary of� ard of Review te �� . �
a oos- 07 0� �� �6a s/
7-�- 9� B- °-�' `�-�. P P
I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 �
Signa re (owners full name) Person authorized by duly executed Power of Attorney o�
by IC�6-1.1-12-.07).
Fvull sident Address of Aplicant Address of Authorized Person �
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