HomeMy WebLinkAboutMortgage_McEllhiney (8)�i � STATEMENT OF MORTGAGE OR CONTRACT INUtEi'i Et71�SS
�FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R6 / 5461
� Presrnbed by Depanment of Local Gwemmenl Finance
INSTRUCTIONS: � I _ _
To be filed in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: 1) Real Property: During the 12 months before ,lune 11 0/ the year the deductid,pJl�s{ t�S�e�7ve.
2) Mo6ile Homes assessed under lC 6-1.1-7: Between January 15 and Ma�ch 2 0/ the year the deductlon is to be eftective.
See reverse side for additional insWctions and qualifications. ��-yj �,
O'��
_ ,.,r.onu cnl1NTY AUDITOR
(owne� or contract buyer - see
Tacing DistrjFt -'
1/ �
1 n,�,Y,���
Assessed value of real property as of
March 1, current year
on reverse side)
f� C �° 0(� Q,
Key number / legal description
� b-ia _�1- a.o�► -m.i
Mortgage / Contract indebtedness
March 1, ^rrenl year 35 �
Recordnumber��n u ••�
Page number
as of Is the applicant the sole legal or equitable
i, ,3 (� owneR ❑ Yes ❑ No
Q
If no, whaf is his / her exact share ot interest? If owned wifh someone olher lhan spouse, indicate with whom.
If name on record is different than that of appticant, indicale b=1ow: Is the property in question:
mortgagee or contrad seller �
Address of mortgagee or contracl seller (number and street, city, state, ZIP
Name of assignee or
Address
owner or holder of mortgage
(number and streef, city, state, ZIP code)
Does applicant own property in any other If yes, what wunty? What Taxing C
county in Indiana?
\, ��- 1 P� �� COUNTYAUDITOR
�l S — _
Deduction approced in the amour,t of:
20 V' 1 � 20
�
Signature
20 V 7 20 20
/
County Auditor
Property ❑ Mobile Hmie pC &1.
v,-.,������ �vo.�.P.�.�..-. u99 `
C:I t'v 1�� � . .....................
n
propeny w� w����„ �__.. — . -- Jo
20
Date
20
We certify under the penalty of perjury lhat the above and foregoing informalion is triie and correct and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
7
address of applicant
�. s -- --
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person