HomeMy WebLinkAboutMortgage_Johnson (9),�s"'E STATEMENT OF MORTGAGE OR CONTRACT
� INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
VALUATION State Form 43709 (1-90) Prescribed by the
�� State Board of Tax Commissioners
� .
Instructions for filing:
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 to be effective. See reverse for additional instructions and qualifications.
Township I Year
JUN 16 1999
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Applica (O ner or contrac e- see re trictions on reverse)
Ta in i ct Key Number/Legal Description Record No.
D/�—(�`SS �–� Page No.
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the sole legal or
of March 1, current year as qt�l'arc 1, current year. , equitable owner? � yes O no
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If no, what is his/her exact share or interest? If owned with someone other than spouse,
indicate with whom.
If name on record is different ihan that of applicant, indicate befow:
Name of mortgagee or contract selle �
dress of mortgagee or contract seller
Name of Assignee or other owner or holder of Mortgage.
Address of Assignee � -
Does applicant own real property Ii yes, what county? What Taxing District? Has this deduction been
in any other county in Indiana? requested on property for current
year? ❑ yes � no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
t s� 19� DD _ b � DQ3 ��[� },�o�r 1 s�`
)')1 `.a�- o� � -/ - o�. •
Signature 0 (��, b� _ Secretary of Board of Review Date
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I/We certify under penalty of perjury that the above and foregoing information is true and correct and that ttie appli-
^ nts was/were a resident of Indiana and owner of the aforementioned property on March 1, 19
ature (owners full ame) Person authorized by duly executed Power of Attorney or
� by IC 6-1.1-12-.07).
Resident Ad ess of Aplicant Address ot Authorized Person
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