HomeMy WebLinkAboutMortgage_Poolei�� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
�' FOR DEDUCTION FROM ASSESSED VALUATION
�• _. «�. � Siate Fortn 43709 (R6 / 5-06)
Prescnbed by Depariment of Local Gwemment Fnance
Coun Township Year
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INSTRUCTIONS: File Maric
To be filed in person or by mail with the County Auditor of the county where the property is located. �`/�AY �`1, ZQ� ]
Filing Dates: 1) Real Properiy: Du�ng the 12 months before June I1 0/ the year the deduction is to be effective.
2) Mobrle Homes assessed under IC 6-1.1-7: Between January 15 and Maich 2 of the yea� t1�g��ductioA is to be effective.
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See reverse side for addifional instnictions and qua/i�ca6ons. Q (f
^ OIBSON COUNTY AUDITOR
(owner or
District
Assessed value of real property as of
March 1, current year -
number / legal description
March 1, current year
3� � � � �
Record number
age number
as of Is the appli
owner?
c me soie iega� or
� Yes � No
If no, what is his / her exact share of interest? If owned with someone oiher than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
0 Real Prq�erty 0 Mobile Home QC 6�1.1-7)
e of moRgagee or contract seller �
Address of mortgagee or contract seller (number an streef, city, state, ZIP
Name of assignee or other owner or holder oi mortgage
Address oi assignee (numberand�street, city, state, LPcode)
Does applicant own property in any oiher I Ii yes, what county?
county in Indiana?
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i
Signature
Wha[ Taxing District?
COUNTY AUDITOR
approved in the amount ot .- -- --
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Has this deduc6on been requested on
property for arcent year? ❑ YesO No
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ceRify undE . �_.,_., ��e� uie aoove and foregoing infortnation is We and correct and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
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or by IC 6-1.1-12-.07
person