HomeMy WebLinkAboutMortgage_Morrison (10)� R�n
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STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R4 / 10-Ot)
Presuibed by DepartmeN of Local Govemment Finance
INSTRUCTIONS:
To be �led in person or by mail with fhe County Auditor o/ the county whe2 the properfy is
Filing Dates: 1) Real P�operty: Ouring the 12 months belo�e May 11 0l the year the deduction is to be �� ti q�pU1
2) Mobile Homes assessed under IC 6-1. 7-7: Behveen January 15 and March 31 0l the yea7 ihe��duction is to be eBective.
See reverse side (or additional instructions and qualifications.
�ntract bu er - see
,1�0� ,
Disirict
on reverse side)
Key number / legal description
d / 5-0�7 3 � �
Record number �^ /
.)
Page number
.
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole Iegal or equitable
March t, current year March�urrent year owner? ❑ Yes ❑ No
S� s �
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is different lhan ihat of applicanl, indicate below: Is the property in queslion:
of mortgagee or contred seller
Address of mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of morigage
Address of assignee (number and street, city, state, ZIP
Does applicant own property in any olher If yes, what county? What Taxing District?
county in Indiana?
Deduction approved in the amount of:
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COUNTY AUDITOR
20 D� 20 D 20
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County Auditor
❑ Real Property ❑ Mobile Home (IC 61.1-�
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Has this dedudion been requested on
property for current year?� Yes� No
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certify under the penalty of perjury that the above and foregoing information is true and correcf and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
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5 • /bFA 12_.T
Person authorized by duly executed Power of Attomey
or by IC 6-t.t-12-.07
of authorized person