HomeMy WebLinkAboutMortgage_Kidd��� 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i' � FOR DEDUCTION FROM ASSESSED VALUATION Count rn ship
��/ • State Fortn 43709 (R6 / 5-06) ' � � ' -� ' '
Presaibetl by Deparimenl of Local Govemment Finance
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INSTRUCTIONS: `File,Mark�
To be tiled in person o� by mail with the County Audito� o( lhe county where lhe p�operty is located. � ����
Filing Dates: 1) Real Property: During the 12 months be(ore ,lune 11 of the year the deduction is to be ef/ec�Hi�SON COUNTY qUn�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to 6e etFec��.
See reverse side for additional instructions and quali(ications.
Appi' nt (owner or contract buyer- s e restrid'ons reverse side)
Taxing Distrid Key number / legal desuiption . Record number �QO �
� _�/ � / � ��� �Q �fCSl9, Page number / �
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Assessed value of real property as of Mortgage / Contred indebtedness unpaid as of Is the applicant.the sole legal or equitable
March 1, curtent year March t, current year ' ownef? ❑ Yes � No �
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If no, what is his / her exacl share of interest? If owned with someone other than�pouse, indicate with whom.
If name on record is difierent ihan that of applicant, indicate betow: Is the property in question:
. ❑ Real Property ❑ Mobile Hmie QC Cr1.1-�
e of mortgagee or contrad seller /� ,� . -- - - — -
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Address of mortgagee or contrad seller (number and street, crty, state, ZIP ;', DI'1�1'CC ����D�G .......
Name of assignee or other owner or holder of mortgage C� C(j �TO. f.� ...............
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Address of assignee (num r and reet, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wnent year? 0 Yes ❑ No
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COUNTY AUDITOR
Deduction approved in the amounl of:
20 ___QQ 20 0 20 20 20 20 20
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Signature County Auditor Date
We certify under lhe penalty of perjury thal lhe above and foregoing information is true and corred and that the applicants was / were
_ resideni of Indiana and owner of the aforementioned property on March 1, 20
Signa r owners lull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
ull residen ad ress of applicant �r � n c cto � Address of authorized person
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