HomeMy WebLinkAboutMortgage_FidlerSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. �� ! State Fortn 43709 (RS / 4-03) � 7,J- , �
PrescriDed Gy Department of Local Guvemment Fina�e , `I I -� �
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INSTRUCTIONS: FEB l��ec¢oV
To be filed in person or 6y mail with the County Auditor of the county whe2 the propeRy is located. /-,
Filing Dafes: 1) Real PropeRy: During the 12 mon[hs 6efore May 11 of the year the deduction is fo 6e eflective. �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0l the��year.the�dedudion:is.to.beneH�tive.
See 2verse side for additional instructions and qualifications. � GIBSOPI CvOUrJT Y AUD;TOR �
Applicant wn rorcontractbuyer-s stri
�
Taxing istrid
�.�-�-�-�
Assessed value of real properiy as of
MarcFi 1, current year
If no, what is his / her exad share of interest?
on
Key number / legal description
number O �
oi 9- oaaoa- �� Page number �
MoAgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March 1, curreqtyear owneR 0 Yes ❑ No
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
,ime of mortgagee or conVact seller L/)�� ,,� 1—�
i
� '�d/l/
Address of mortgagee or contrad seller (number and stieet, aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, sfate, ZIP code)
Does applicant own property in any other If yes, what wunty?
county in Indiana?
Dedudion approved in the amount of:
20 20 � 20 �
%� P
Signature
coui
Is the property in question:
❑ Real PropeAy ❑ Mobile Home QC 67.
Drawer NO...... ••••""�'�/ tion been requested on
O�. _�Q�� / rent yeaf? � Yes ❑ No
Card NO• : "
� j
,
20 �� 20 Qq_
� P
County Auditor
�
20
the penalty of perjury that lhe above and foregoing informalion is true and corred and lhat the applicants was / were
a and owner of the af�mentioned property on March 1, 20
full
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
person