HomeMy WebLinkAboutMortgage_Downey (3).+.�*A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'= FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Form 43709 (RB / 2-07�
� Presaibed by Department of Local Govemment Finance
To be filed�n person or by mad wdh the County Auditor o/ fhe county where the piopedy is located. �� I�M� �
Fdrng Dates: 1) Real Property: Dunng the 72 monfhs be/ore June 17 0l the year the deducUon is fo be eRective. �L� �,�'
2) Mo6ile Homes assessed under IC 6-t 1-7: 8ehveen January 75 and Maich 2 o/the year the deducSon is to be eflective.
See reverse side tor additional insWCtions and qualifications. /� U � �
J (t�lf3
Applicant (amer n er-see �esMcfi on verse sde) `-y,,,
L � � � � � �/(� ���
Tap isVia / Key nwnber / legal desai ��� _ �b1 7 y �e numbet
i ii ti z ` �C�i �
ralue of real propa�y as of Martl� 1, artenl y�r Mortgage I Contrad ind�
wnenl year . -� �
'�'F-'"�u�
m
Name of mortgagee ot cmVact seller
irMicale below:
Address of rtartgagee or oonUad seller (number aiM slreef. aty. state. and
Name of assignee a aU�er ow�ur or
arrd ZIP crotle)
as ot March 1,
ihB appfimnl IhB sole legdl or equitade owne�
❑ Yes ❑ No
If owned wiU� someone dher Ihan spouse,'u�6cale wilh whom.
Daes applicant own propeny in any olhe
counry in Indiana? _� / G
❑Yes ❑ r,. Drawer NO...... lO....... �
Is Ne quperty in Question:
❑ Real PropeAy ❑ MoWle Home
Has Uds dedu�liw� been requesled on property
r« a,R�n yean
❑Yes ❑No
ductbn appro✓ed in Ihe amouN of: l..ard � � . ................
�.�l/� /l, c/`lj/, 7 �
zo zo _ zo _ 2o zo zo _ zo _
�
e nty ' r Counry Oale ( , da . yea
%3 a
1 7 We certify un er the penal of perjury tliat Ih above and foregoing infortrwtion is tnie and correG and thal the applicants was I were a residenl of
Indiana and owner of the a w entimed prop rty rn March 1, 20
natureAownelslufM3me1 Date (monN, day, yea�
atltlress
cify. stale. aiM ZIP cvde)
authoiize0 by duy executed Power of Altomey w by IC
Address of auttrorized peison
Date (rrimlh. day. yea�