HomeMy WebLinkAboutMortgage_McGillem (7):�
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STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNFce
FOR DEDUCTION FROM ASSESSED VALUATION
Siate Fortn 63709 (RS I 4-03) - �
P25criDed Cy Department ot Local Govemment Finance �
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor of the county where the property
Filing Dates: 1) Real Property: Dunng the 12 months before May 11 of the year the deduction is ��8el�cfiv���0
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of t e year the deduction is to be ef(ective.
See reverse side for additional instructions and qualifications. /�'.�
`2'la� N , V
_._...,.� cOUNTY AUDITOR
�OWnBf O! COnIf2Ct �f1�Cl'} SCB
Taxing Distrid
Assessed value of real property as of
March 1, wrrent year
Ii no, what is his / her exact
number / legal description
���/9-0 /; G �;oa
number
Page number
Mortgage / Contrecl indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year owneR ❑ Yes ❑ No
�. (c;(� 00
If name on record is different than that of applicant,
of moAgagee or contrad seller
below:
Address ofmortgagee or contract seller (number and street, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and slreet, ciry, state, ZIP code)
Does applicant own property in any olher I If yes, what county?
cuunty in Indiana?
Deduction approved in the amountof:
20 // / ( 20 �
�
�
owned with someone other than spouse, indicate with whom.
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ZIP
What Taxing District?
COUNTY AUDITOR
20 _Q� 20 20
r
County Auditor
ie property in question:
Real Property ❑ Mobile Home
Has this dedudion been requested on
property for current yeaR � Yes ❑ No
20
Date
20
We cedify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
of applicant_ �Address o( authorized person