HomeMy WebLinkAboutMortgage_Kenoyer��
� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�+ ���� ! State Fortn 43709 (RS / 4-03) �
� Presaibed by Depanmem of Local Govemmeni Finance
iNSrRUCnorvs: $EP 1 4 ��p�a,�
To be filed in person or by mail with the County Auditor o/ the county where the property is located.
Filing Dates: 1 J Real Property: During the 12 months 6elore May 11 07 the year the deduction is to be eflective. ���
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o(the yea��deducfrb�i is fo be effective.
See reverse side 1or additional instructions and qualifications. ��BS�N CO NTY AUDITOR
ouyer-
Taxing �i, trict '
�✓ W r �
�
Assessed value of real properiy as of
March 1, current year
no, what is his / her exac[ share of
If name on
2 to-�a -� 8-.'to� -cba.
0/q -�a00�
Mortgage / ContraIX indebtedne:
March 1, current year
�� C�wnedw�
than lhat of applicant,
moAgagee or contrad seller
of mortgagee or contraIX seller (number and street,
o( assignee or other owner or
mortgage
of assignee (number and sfreet, city, state, ZIP code)
Does applipnt own property in any other I If yes, what counry?
county in Indiana?
Deduction approved in the amount of:
20
�
Signature
� •:
J
state, ZIP
number �/±� / _
���«�
�` Page number
�.�
unpaid as of Is the ap�
owner?
n�.,/
ec�
What Taxing District?
COUNTY AUDITOR
20� 20 20
�
County Auditor
55 ��
t the sole legal or equitable
❑ Yes ❑ No
other than spouse, indicate wilh whom.
Is the pr
❑ Real
�
❑ Mobile Home (IC 61.1-�
a�e �e1�� 2r
Has this deduclion been requested on
property for current year?(] Yes� No
20
Date
20
We certify under the penalty of perjury that lhe above and foregoing information is true and corred and that the applicants was / were
�es�nt of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
o'f \authorized person
V