HomeMy WebLinkAboutMortgage_Garrett (4)�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
s' = FOR DEDUCTION FROM ASSESSED VALUATION
J State Fwm 43709 (R6 / 5-06)
Presvibed by �aperiment of Loral Govemment Finance
� •
INSTRUCTIONS:
C Township Year
MAY 1 S 2007
File Mark
To be filed in person or by marl with the County Auditor o/ the county where the propeRy is located. �-y�,
Filing Dates: 1) Real Property: Dunng the 12 months before June I1 0/ the year fhe deduction is to be effectiJe!6ti^ �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and Maah 2 of the y����B��R�,�.ss�g�ctrve.
See reverse side for addftional insfiuc6ons and qualifrcations.
Applicant (owner or cont2cf buy - s restnbfions on reve se side) .
Taxing District Key nu er / legal description Record number Q
A � - , � .� Page number D
V
Assessed value of real property as of Mortgage / ConVact indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owner? � Yes � No
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 of applicant, indicate below: Is the property in question:
❑ Real Properly O MoMle Home (IC 61.1-7)
� e of mortgagee o conUact seller �
Address of mortgagee or contract seiler (number and strset, ty, state, ZIP
Name oi assignee or other owner or holder of mortgage
Address oi assignee (numbe� and street, city
Dra�vcr NOO.? � o `_ �o �G
Does applicant own property in any other If � """""" Has this deducdon been requested on
wunty in Indiana? •�. �. '�.- ' property for wrtent yeaR ❑ Yes❑ No
' C�C(� 1�1� . ................. .
Deduction approved in the amount of:
20�� 20�� 20 20 20 20 20
� �
Signa[ure Counry Auditor Date
I I We certity under the penalty of perjury that the above and foregoing infortnation is We and correct and that the applicants was / were
sident of Indiana and owner of the aforementioned property on March 1, 20
o� nature (owner (ull name) Person authorized by duly executed Power of Attomey
�, or by IC 6-1.1-12-.07
F II resident address of applicant Address of authorized person
� OtN �'
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