HomeMy WebLinkAboutMortgage_Garrett (5)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Ye
:. «� I State Form a3709 (R5 / 4-03)
� PrescriDetl Dy Department ol Loca� Govemment Finance
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INSTRUCTIONS: �i � �� File Mark !
To 6e (led in person or 6y mail with the County Auditor of the county where the property is located.
Filing Dates: 1J Real Pioperty: During the 12 months before May 11 of the year the deduction is to b� p.�ect�v �
2) Mobile Homes assessed under IC 6-1.1 J: Between Januarv 15 and March 2 0l the vear the ded�,Q{I is to ne eBectiva
See reverse side for additional instructions and qualifrcations. ,� �j �)
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Applicanl (owneror contract ee stnctions on reverse si -""" '
Taxing Dislrict Key nu r/ legal description Record number /��
g� Q i� y �
l'/ //- bo8 a-a� Page number /��
Assessed value of real property as of MoAgage / Contrect indebtedness unpaid as of Is lhe applicant the sole legal or equitable
March t, wrrent year March 1, current year ownef? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is difterent than that ot applicant, indicate below: Is the property in question:
❑ Real Pro ❑ Mobile Home QC 61.1-�
"�me of mortgagee or contract seller ��
Address of mortgagee or contracl seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this deduction been requested on
county in Indiana? property for current year? � Yes � No
COUNTY AUDITOR
Deduction approved in the amounf of:
zo zo �_ zo �� zo 09 2o zo zo
P � P
Signature County Auditor Date
We certify under the penalty of peryury that the above and foregoing information is true and corcec[ and that the applicants was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20
Signature.,(owners tull name) person authorized by duly executed Power of Attomey
�f' . �j ---�_ or by IC 6-1.1-12-.07
ulI resident addres 'of ap � Address of authorized person
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