HomeMy WebLinkAboutMortgage_McKannan�STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
•� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
` State Fwm a3709 (R5 / 4-03)
P2scnDed by Department of Loral Government Finante •—��'� � � ���` �
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iNSrRUCnorvs: SEP U a L�03
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 May 11 of the year the deduction is to be elfective.
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year th,e� d�edu5c,tion �s�t�t�o�be� �eflecti've.
See reverse side !or additional instructions and qualifrcations. �?t3cpt_- -! �'!� ;��.; �w ,,� ��
Applicant (owner
Taaing
see
Assessed value of real properly as of
��larch 1, current year
If no, what is
If name on re
e of mo�
Address of r
Name of ass
/ her exact share o( interest?
side)
�!�
Key number / legal d nption Record numb
�� _O/�`� Pagenumber
J
Mortgage / Contract indebtedness unpaid as of Is the ap
March 1, current year O owner?
3so oa ��oo
D 3- 7� �s :
DrawerNO ...............
CardNO . .....................
_. _. .._._... .., .,, �.yay�
(numberand street, city, s[ate,
c me soie iegai or
❑ Yes ❑ No
If owned wiih someone other than spouse, indicate with whom.
�
t, city, state, ZIP
�—
��
��. �
❑ Mobile Home (IC 67.1-
Does applicant own property in any other If yes, what county? What Taxing Distrfct? I Has this deduction been requested on
county in Indiana? property for wrrent year?� Yes❑ No
20
approved in the amount of:
20 c� '� � 20
COUNTY AUDITOR
20 O,
/�
County Auditor
� Y:�
20 O
�
Date
iZi7
certify under the penalty of perjury that the above and foregoing information is We and corred and that the applicants was /were
lent of Indiana and owner of the aforementioned property on March 1, 20
Person authonzed by duly exewted Power of Attomey
or by IC 6-1.1-12-.07
=lu—ll r�sid�t addY�ss 6f applicant `' �' ��N���� Address of authorized person
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