HomeMy WebLinkAboutMortgage_Hightower`�"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�'�-- s FOR DEDUCTION FROM ASSESSED VALUATION
� State Form 43709 (R / 12-99j
Presfxibed by State Board of Taz Commissioners
Instructionsforfiling:
To be filed in person or by mail with the County Auditor of the county where the property is
located during the 12 months before May 11 of the year the deduction is lo be eHedive. See
reverse side for additional instructions and qualifications.
Applicanl
Tazing District
orcontract 6uyer- see restn
M M 1l1. � �l'
value of real propeRy as of
March 1, current year
If no, what is his / her exact share of interest?
on rgverse side)
FORM 5
Filing fee 51.00
Coun Township Year
File Mark
��BJ��
MAR 12 2001
Key number / 1(�e al description / � Record number O�
V �
QI _ � `) � —QO Page number
Mortgage Contract indebtedness unpaid as of Is the applicant the sol legal or equitable
March 1, current year � i owne(? ❑ Yes ❑ No
���yOs �
If owned with someone other than spouse, indicate with whom.
If name on record is different lhan that of applicanl, indicate
of moRgagee or contred seller
Address of mortgagee or coniract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6erand street, city, state, ZIP code)
J� �C./ �
Does applicant own real property in any If yes, what county? What Taxing District? Has this deduction been requested on
other county in Indiana? property for current yea(? ❑ Yes❑ No
PROPERTY TAX ASSESSMENT BOARD OF APPEALS
Deduction approved in the amount of:
20 �_ � 20 fZ.� � 20
�3, o�
20� 20
�
Signature n 9 Secretary of PTABOA
� P
20 �'� 20
P
Date
�
/ We certify under the penalty of perjury that the above and toregoing information is true and correct and that the applicants was / were
� resident of Indiana and owner of the aforementioned property on March 1, 20
(owners
resident addi
3�0
Person authorized by duly
or by IC 6-1.1-72-.07
otauihorized person