HomeMy WebLinkAboutMortgage_Fisheacke��� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�J SUte Fartn 43709 (R615-OG)
� Presaibed 6y Depertment af �ocal Gwemment Finarice
INSTRUCTIONS: ��Fi Mark� �^�
To be filed in person or by mail with the County Auditor of the county whe�e the p�operfy is located. �� i �
Filing Dafes: 1) Real Property: During the 72 months 6e/ore June 17 of the year the deduction is to be eflective. �� 1 �
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 of the year the dedyFtion is to be eHec rve.
MA1 2 1 2007
See reverse side for additional instructions and qualifications.
or cont2ct buye� - see
r-� a6-�
Assessed value of real property as of
March 1, current year
no, what is his / her exact
I( name on record is difterent than that of
of mortgagee or contract seller
Key number! legal description
.�
07�,.,�.GC�m3 �9� oa� Pagenumber
Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1,�c7u'grrent year owner? Q Yes � No
�] . V c/ "'
If owned with someone other than spouse, indicate with whom.
ot mortgagee or contract selier (number and street, city, state, ZIP
Name of assignee or other owner or holder �
Address of assignee (num6er and street, crh
Does appliqnt own property in any other Ii �
county in Indiana?
20
Signature
approved in the amount of:
�
�p,,�,;�, m
�/4�
�a�- aG��
COUNTY AUDITOR
20 � `i 20 20
�
County Auditor
❑ Real
0 Mob�e Home pC 61.
Has this deducfion been requested on
property for current year? ❑ Yes❑ No
20
�
We certiy under the penalty of perjury that the above and foregoing infortnation is We and corteci and that the applicants was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20
duly executed Power of Attomey
or by IC 6-t.t-12-.07
ofauthorized person