HomeMy WebLinkAboutMortgage_Phillips (10)�ai �' .� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
's'�i= FOR DEDUCTION FROM ASSESSED VALUATION - Count Township Year
�+ State Fwm 43709 (R6/ 5-06)
�«• Prescnbed by Deparimem ot lo�al Govemment Finance
INSTRUCTIONS: - � � � q Fi1�9NaN
To be filed in person or by mail with the County Auditor ol the county where the p�operty is I ted.� �J �J 1L!
Filing Dafes: 1) Real Property: Dunng the 12 months before ,lune 11 of the year the deduction is to be effec�ive. n7
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 0/ the �th �dZQtron is fo be effective.
See reverse side foradditional instructions and quali�cations.
/ �^? ,Q�
Applicant
Taxing District
buyer-see
Assessed value of real properly as of
March 1, current year
If no, what is his / her exacl share of interesl?
If name on
mortgagee or contrad selier
srde)
Key number / le I d suiption Record number
�.�-ia-o - o�-aoa.os�-aa8
%1 /n� ���� _O Page number
(J i
Mortgage! Contract indebtedness unpaid as of Is the applicant ihe sole legal or equitable
March 1, currenl year owne(? ❑ Yes ❑ No
S9oc� �
If owned with someone other than spouse, indicate with whom.
indicate below:
Address of mortgagee or conVact seller (number and stieet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, : _ /
Dra�r�cr NO.����?:.S?�:��
Does applicant own property in any other If ye '
county in Indiana?
Cal"C� �7� . .........::..........
Dedudion approved in the amount of:
r�l
Signature
� •;
liVV1�111 MUVllvn
20 � 20 20
P
County Auditor
❑ Real Property ❑ Mobite Home (IC 61.
Has this deduction been requested on
property for curtent yea(? � Yes ❑ No
20
20
' We certify under the penalty of peryury that the above and foregoing information is true and corred and lhat the applicants was ! were
resident of Indiana and owner of the aforementioned property on March 1, 20
�n/�Ws�� (owners full name)n 1 Person authorized by duly executed Power oi Atlomey
\Y� In nn �... � i. 1( .� 0 n 1\ or by IC 6-1.1-12-.07
Q ` — \,`�-NAddress of authorized person
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