HomeMy WebLinkAboutMortgage_Greene (7)R�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-' = FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
S / State Form a3709 (R4/ 70-07)
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PrescribeE by Department of Local Govemmeni Finance
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INSTRUCTIONS: � de M n cl� �
To be filed in person or by mail with the County Auditor o( lhe county where the property is located.
Filing Dates: 1) Real Property: During the 12 months be(ore May 11 olthe year the deduction is to be e(fecti�P � n�nn�
2) Mo6ile Homes assessed under IC 61.1-7: Behveen January 15 and Ma�ch 31 of the year the educ ioi{ i uL e(/ecfive.
See 2verse side for addifional instructrons and qualifications. � i//
Applicant (owner or c rac uyer- see resMctions on reve side) �� � R
Taxing Dis ' Key number / legal description Record number �
i � � / q— /ti / O �(` OO Page number / / � p /
/ V 7• 0
Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March 1,�u_rrent year owneR ❑ Yes ❑ No
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If no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different lhan that of applicanl, indicate below: Is the property in question:
_- ❑ Real Property ❑ Mobile Home pC G1.1-�
of mortgagee or contrad seller
Address of mortgagee or wntract seller (number and st2et, city, state, ZIP
Name of assignee or olher owner or holder of mortgage
assignee (num6erand st�eet, city, state, ZIP code)
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Does applicant own properfy in any other If yes, what county? What Taxing District? Has lhis deduclion been requested on
county in Indiana? property for wrrent yea(? O Yes � No
Deduction approved in the amount of:
20 �� 20 � 20
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Signature
COUNTY AUDITOR
20
County Auditor
20 U./ 20 i)iS. 20 D'
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Date
certify under the penalty of perjury that the above and foregoing informalion is true and corred and that the applicants was / were
ient of Indiana and owner of the aforementioned property on March 1, 20
ire (owners full � Person authorized by duty executed Power of Attomey
,�� � �� � or by IC 6-1.1-12-.07
�esiaen`aaaress ot appuqnt Address of aulhorized person
S05 S. S�'o�,..� S�Y. r�r1LC.�on,� g