HomeMy WebLinkAboutMortgage_Pauley`° rt�"° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�" = FOR DEDUCTION FROM ASSESSED VALUATION ^Count Township Year
• � J State Form 43709 (R4 /10.07J / 1 , ��
PreSCribeE by Depariment af Loral Govemment Finance
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INSTRUCTIONS: File Mark
To be filed in person or 6y mail wilh the County Auditor of the counly where the property is located. —'—t '— '� '�11
Filing Dates: 1) Real PropeRy: Dunng the 12 months 6efore May 11 of the year the deduction is to be eRective��� �� I`"� �I
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0( the year the deduction is�to•tie�eNective�
See reverse side lor additional inst�uctions and quali�cations.
F E B 0 � 2002
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Applicant (owner or contract 6uye - ee restrictio on revers si e)
GI88CP! CC�!v i Y AUDITGR �
Taxi isirid ey number / legal description — Rewrd number y�
1 CJ �
O O�rO � Pagenumber
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Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year ' owner? �s ❑ No
�Q O
If no, what is his / her exact share of interest? If owned with someone olher than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home (IC Cr1.1-�
�e of mortgagee or contrad seller
Address ot mortgagee or contrad seller (number an , city, stat , P ,
Name of assignee or olher owner or holder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for current year? � Yes� No
COUNTY AUDITOR
Deduction approved in the amount of:
20 ' 20 �_ 20 200 20 20 � 20 _� �
5 �, � � P
—;- Sig` lure County Auditor Date
�' Ne certify under the penalty of perjury lhat the above and foregoing information is true and corred and that the applicants was / were
;ident of Indiana and owner of the aforementioned property on March 1, 20
i nature ( ners (ull name Person authorized by duly executed Power of Atlomey
� or by IC 6-1.1-12-.07
I FuU reside ddress of applicant � Address of authorized person