HomeMy WebLinkAboutMortgage_Morrison (13)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' ' FOR DEDUCTION FROM ASSESSED VALUATION �Coun Township Year
ti � State Form 43709 (R4 / 10-Ot ) � K + �
� «.
Prescri0e0 Dy DepaNrent W Lotal Govemment Finance g
j � 2
INSTRUCTIONS: File F1003
To be filed in person or by mail with the County Audifor of the county where the property is located.
Filing Dates: 1) Real Pioperty: During the 12 months be(oie May 11 0/ the year the deduction is to e e(/ec�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 of t yep�� e eduction is.t eHective.
� �VJ�IV: 1
See reverse side /or additional instructions and qualifica6ons.
Applicant (owner or contract buyer - see re tricUon on reverse ide)
Taxing Distrid Key n r/ legal description Record number
/ - �
Page number
- ay •�
Assessed value of real property as of MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March t, wrrent year March 1, curtent year ownef? ❑ Yes ❑ No
�O��o.
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 than that of applicant, indicate below: Is th roperty in question:
Real Property O Mobile Horne pC Cr1.1-�
me of mortgagee or contrad eller _
Address of mortgagee or contract se er (num r and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
�.�, �l� . - � .�
Address of assignee (number and stieet, city, state, ZIP code) Q
Does applicant own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for wrtent yeaf? � Yes ❑ No
COUNTY AUDITOR
De uction approved in fhe amount of:
zo 0�_ zo �� Zo O� zo � 20 � zo �_ zo �
D • � � I
Signature County Auditor Date
We certify under the penalty of perjury that the above and foregoing infortnation is lrue and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) ' Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full resident addres applipnt Address of authorized person
O ��c� �