HomeMy WebLinkAboutMortgage_Dunlap (2)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
� �w� ! State Form 43709 (RS / 4-03) . �,� �
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P�escnDeO by Department of Lordl Gtivemment Finance �`
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To beRf �TIOP �on or by mail with the Counry Auditor of the counfy where the property is located. F E B 1�il€���1c
Filing Dates: 1) Real Property: During fhe 12 months before May 11 of the year the deduction is to be ellective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 oI the�year the.deduction is to be effective.
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See reverse side for additional instructions and qualifications. , G,ggOW C".
Applicant (owne� contract buyer
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Taxing Distrid
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2strictions on
/ iegal description � �/ I Record number �� �
�/ ^' O a 7_ � Page number /� O
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Assessed value of real property as of Mortgage / Contrad indebledness unpaid as of Is the applicant the ole legal or equitable
March 1, cunent year March 1, current year ownef? es ❑ No
D� d
If no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diHerent than that of applicant, indicate below: Is lhe prgperty in question:
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mortgagee or contrad seller
Address of mortgagee or wntract seller (number a�{istieet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand st2et, city, sfate, ZlPcode) — _ _
Does applicant own property in any other If yes, what county? N DiaWCi' NO ................... 'n requested on
county in Indiana? - af?� Yes❑ No
Card NO. !./..�.:.. 9!a�
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Oeduction approved in the amount of:
20 �,� 20 % 20 f�
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Signature
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P I P
County Auditar
20
Date
20
We certify under the penalty of peryury that the above and foregoing infortnation is true and correct and that the applicants was / were
esident of Indiana and owner of the aforementioned groperty on March 1, 20
full
Person aulhorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
Address of aulhorized person