HomeMy WebLinkAboutMortgage_Przymus/i �} STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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'�FOR DEDUCTION FROM ASSESSED VALUATION
+ Stete Form 43709 (R6 / S-06)
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� Prescribed by Depariment of Lodl Govemment Finance
INSTRUCTIONS: � � � ile k�
To be filed in pe�son or by mail with the CountyAuditor of the county where the property is locat �"��
Filing Dates: i) Real Property: Dunng fhe 12 months 6efore June I f of the yea� the deduction is to be eBective�. 9 �n(�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the ye�dAdbCtidlt'�� to be eNective.
See reverse side for additional instn�ctions and qualifications.
(owner or
Tauing Dislrid
buyer-see
Assessed value of real property as of
March i, current year
If no, what is his / her exact share
on
side)
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Key number / legal dEscription ecord number ��D �
� � /� �� � � d �3 � Page number � O 7 J
v ��z. aG6 -oaa
MoAgage / Contrad indebtedness unpaid as of Is lhe apptipnt the sole legal or equitable
March 1, current year owneR ❑ Yes ❑ No
��O C�
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate
mortgagee or conVact seller
�
Address of mortgagee or contrad seller (number and st
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sGeet, city, state, ZIP code)
Does appliwnt own property in any other If yes, what county?
county in Indiana?
Deduction
20� 20
�
Signature _
the amounl of:
�
s the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
state, ZIP , ��'^p
Dra«�e►• NO.P�S..f/v..'.��%s
, • .
� . � = :
Car NO.. ' .
'"/.���.�...�,.��5� SGO.°�
�1 i anuiy �wo�c�r ��e� ����� �ewcuon oeen requested on
a I property for current yeaR 0 Yes ❑ No
COUNTY AUDITOR
20 20 20
County Auditor
�
Date
20
certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
(owners /ull name)
(� y� �T
''(f : nc�ies+17`i
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person
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