HomeMy WebLinkAboutMortgage_Figgins/ei �� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`\i�� FOR DEDUCTION FROM ASSESSED VALUATION
`� «. ! State Fwm 43709 (R6 / 5-06)
� Presaibed by Oepartment of Local Govemment Finaixe
INSTRUCTIONS:
To be filed in person oi by mail with the County Auditor of the county where the property is located.
Filing Dates: 1) Real P�operty: During the 72 months 6efore June I i o( the year the deduc6on is to be el%ctive.� �
2) Mobile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 of the year the dedu�6on O Co ����ective.
See reverse side fo� additional instructions and qual�cations. �� ��
�-1 .
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of interest?
si�e) .
Key number / legal d tio 7�,�� Record number "
t �-/a o� n•9
/�" I Q : �'a 9 / ?.. Q � Page number � /�
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Mortgage / Contrad indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March 1, current year owne(? ❑ Yes ❑ No
� �04 O
If name on record is dif(erent than that of applicant, indicate below:
me of mortgagee or contrad seller ,
Address of mortgagee or wntrad seller (number and street, city, s
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street,
Dces applipnt own property in any other I If yes, what county?
county in Indiana?
If owned with someone other than spouse, indicate with whom.
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Is the property in question:
❑ Real Pmperty ❑ Mobile Home pC G1.1-
�
What Taxing Distrid? Has this dedudion been requested on
property for current year? � Yes ❑ No
COUNTY AUDITOR
Dedudion approved in fhe amount of:
20 fL� 20 �s 20 0� 20
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Signature
County Auditor
20
20
Date
20
We certify under the penalty of peryury that the above and foregoing information is true and corred and thal the applicants was / were
resident of Indiana and owner of ihe aforementioned property on March 1, 20
Person authorized by duly executed Power of
or by IC 6-1.1-12-.07
of authorized person