HomeMy WebLinkAboutMortgage_Cutsinger (5)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION u o sh Year
:�� / Stata Fwm 43709 (RS I 6-03) � �
� Pmscdbed by Department ot Local G6vemment Finance
INSTRUCTIONS: �ila Mark
To 6e filed in person or by mail with the County Auditor of the county where the propeRy is located. ��'
Filing Dates: 1) Real Property: During the 12 months be/ore May 11 of the year the deduction is to be e,,(�fgrLj�Ty qUDITOR
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of tf%��e�'aYihe deduction is to be eltective.
See reverse side for additional instructions and qualifications.
Applicant (owner or contract buyer ee restnctions on rse sid
Taxing Disi�iq � Key n b r/ gal scnption Record numbe
� 1
� � Page number
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March 1, wrtent year March 1, current year � ownef? ❑ Yes ❑ No
�
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mo6ile Home (IC 67.1-�
�e of mortgagee or contrad seller ' ���
Address of mortgagee or contract seiler (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et, city, sfate, ZIP code)
Does appiicant own property in any other If yes, what counry? What Taxing Distrid? Has this deduclion been requested on
county in Indiana? property for current yea�? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 �_ 20 LJ � 20 20 20
� � P
Signature County Auditor Date
� We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
. .siden a and owner of e aforementioned property on March 1, 20
Si ure (owner (ull Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
de ad ress of a p cant Address of authorized person