HomeMy WebLinkAboutMortgage_Hoke.•��� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'�'��4 FOR DEDUCTION FROM ASSESSED VALUATION
Stale Fortn 43709 (RB / 2-07)
'�; � Presaibed by Depanment of Local Govemment Finance
Year
r !Fi el Ma
INSTRUCTIONS: a �! �
To be filed in person or by mail wdh the CountyAudifor o/ the counfy where Ne property is locafed. - �—J _i�,r
Filinq Dates: 7J Real Property: Durrng the 72 months be/ae June 17 0/ fhe year the deduction is fo be elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 end Maroh 2 of the year the deducfi� �q tqb � 7ktcUy¢.
See reverse side !w addi6onal instruclions aiW quali(cetions. 1 LU y
(owner
of real property as of MarU 1. aarent year
what is his I her ea�acl share of irrterest?
Name of mortga9ee or
Address of rtar�qagce w cmlrad seller (number arq ahee4 dry, stafe, arM Z!P cade)
Name of assignee a other oaner w hdder
Address of assignee (num6ef aM sVBe(. dN. ��. � Z6
Deduction a�
� �
.1 1 i. ��( ,� '
Dra�veC'1��.:���•:"""
Card NO. ....�`�.......
� ��5, Oy3. "�
. %7 /�oZO
fdness unpaid as of March 1,
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Is ihe applicant the sde legal a equitaNe wme/7
❑Yes ❑ No
If awned wilh someone other Ihan spouse,
Vfnal Tezing Disiricl7
COUNTYAUDROR
20 _ � 2�
Is ihe pioperty in quesGOn:
❑ Real P�opeAy ❑ Mobile Home QC 61.
4�
Has lftis dedu�lion been requested on property
t« a,rre�t yean�.
` ❑Yes ❑ No
r.��;
�
Signawre ot Counry Autlitor I CouMy I Dale (monfA, day, yeaA
I/ We certfy under the penalty oi perjury ihat tlie above and foregoing intamation is We and correct and that Ne applicanis was /were e resident of
Indiana and owner of ihe aforemen6oned property on March 1, 20 .__
aulhonzed
Address of
s(afe. aM ZIP oode)
execuled PoNer of Altomey w by IC 61.1
��
Date (monN, dey, yea�
(mmN, daY.Y��