HomeMy WebLinkAboutMortgage_Lloyd (9),.,T•�a STATEMENT OF MORTGAGE OR CONTRACT
� A` INDEBTEDNESS FOR DEDUCTION FROM ASSESSED
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' VALUATION State Form 43709 (1-90) Prescribed by the
� State Board of Tax Commissioners
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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.
(Owner or
Taxing District
3ct buyer - see restnctio on
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Key NumbedLeg<
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Record No.
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„(� CFiy�_ Page No. �f2S IJ (O•.
Assessed value of real property as Mortgage/Contract Indebtedness unpaid Is the applicant the ole legal or
of March 1, current year as of March 1, current year. equitable owner?�es ❑ no
in (�(� � '-i�0 d .a%�,Udl� / -
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 than that of applicant, indicate below:
ress
or contract seller
contract seller
Name of Assignee or other owner or
Address
e.
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. 9 `{- 15�9
Does applicant own real property If yes, what county. What Taxing District. Has this deduction been
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in any other county in Indiana? requested on property for current
, year? O yes O no
COUNTY BOARD OF REVIEW ACTION
Deduction approved in the amount of:
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Secretary of Board of Revi
�o6�-P °� °d
Dat�
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I/We certify under penalty of perjury that the above and foregoing information is true and correct and that the appli-
�s was/were a resident of Indiana and owner of the aforementioned property on March 1, 19 .
�nat (owners fuli name) Person authorized by duly executed Power of Attorney or
� " � �Q� ,0 by IC 6-1.1-12-.07).
Address of ApNcant � Address of Authorized Person