HomeMy WebLinkAboutMortgage_Maurer (13)� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
�. M� / State Fortn a3709 (RS / 4-03)
� PrescnUed Ey Depanment ol Local Govemmen� Financa '
yp T7�1 —_
INSTRUCTIONS: - - � A FilO Mar� � ��"
To 6e filed in person or by mail with the County Auditor o) the county where the propeRy is located. 31 _.i.J
Filing Dates: 1) Real Property: During the 12 months before May 11 0/ the year the deduction is to be eRective��p /,
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0( the year the detlutFion�is�to��e'ffective.
See reverse side for additional instructions and qual�cations. /' ��% �
(ownerar
Taxing Dis 'ct
/�'V ' ���
Assessed value of real property as of
March i, curtent year
no, what is his / her exad share of interest?
Key number
� ��'i -ODSaa -�
number
number
MoAgage / Contrad indebtedness unpaid as of I Is the a
March 1, � year owneR
/a/ooc�
If name on rewrd is different than lhat of applicant, indicate below:
ne of mortgagee or contrad seller
Dra�r�er NO ...................
�ooy _ a,3v
Card NO . .....................
,o Yn �� , l a�, 6 0 0. L�
�
I the sole legal or equitable
❑ Yes ❑ No
owned with someone other than spouse, indicate with whom.
�nd street, city, state, ZIP
tgage
�, ZIP code)
�kacP �az�-�
.,, ..... ..................... r..,,....., ... _.., .,..._. . ,,..., ..hat county?
county in Indiana? I
approved in the amount of:
20 Q�_
Signature
20� 20�
.� �
What Taxing District?
COUNTY AUDITOR
��Ii'�
� P
County Auditor
❑ Real Property ❑ Mobile Home (IC 61.1-n
Has this dedudion been requested on
property for current yeaf? � Yes� No
20
Date
20
We certiy under the penalty of perjury lhal the above and toregoing information is true and corced and that the applicants was / were
esident of Indiana and gwner of the afo�entioned property on March 1, 20
Person authorized by
or by IC 6-1.1-12-.07
of authorized person
of