HomeMy WebLinkAboutMortgage_Greene (2)a�` �N
�`_� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
r FOR DEDUCTION FROM ASSESSED VALUATION C t T ns i�'J Year
J State Form 43709 (R6 / SO6) � � -
�• Presaibed by Depariment of Lool Govemment Finarice '�
�L� i
INSTRUCTIONS: File M�/_,
To be filed in person or by mail with the County Auditor of the county where the property is located. � p��o� �� n v
Filing Dates: 1) Rea/ Property: During the 12 months 6efore ,lune !1 0/ the yea� the deduction is fo be elfective. DUNTy pUD���R
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 0l the yearPtl6�e�u�UOn �s to be effective.
See �everse side /or adddional instiucGons and qualifica6ons.
Applicant
Taxing
buyer - see yeffridiqns on reverse side)
Key number / legal description � Record number
- � �^ � n^ � � ^ ^ � ,(�O� age number �
� l o[CJ �JC`/ 1/
Assessed vatue of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable
March 1, curtent year March 1, currenl year owne(? ❑ Yes � No �
If no, what is his / her exact share ot interest? If owned with someone other lhan spouse, indicate with whom.
If name on reoord is different than that of
of moRgagee or conVad seller
Address of mortgagee or conVact seller (number and
Nama of assignee or other owner or holder of mortgage
Address ot assignee (number and street, city, state,
Does applies�t own property in any other If yes, wh.
counfy in Indiana?
�
in the amouni of:
� �.
below:
city; state, ZIP
Is the pr
❑ Real
,ao� _
v v _„�K
20 20 20
County Auditor
20
Date
❑ Mobile Hane (IC &1.1-�
his deduction been requested on
�ty for current year? � Yes ❑ No
20
certity under the penalty of perjury that the above and foregoing information is lrue and corred and that the applicants was / were
lenl of Indiana and owner of the aforementioned property on March t, 20
(owners /ull name)
Person authorized by duly executed Power oi Attomey
or by IC 6-1.1-12-.07
of authorized person