HomeMy WebLinkAboutMortgage_Reed (6)� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�t FOR DEDUCTION FROM ASSESSED VALUATION
�.'�_ ! StateFwrt:a3709(RSla-03)
�«.
PrasaiDetl by Depanment of Local Govemment Finance
�
INSTRUCTIONS:
Coun Township Year
I� � I: i�--� i_ .
11 Y .lVl _1`/ 1L�
SEF"' i"'a`�2003
To 6e filed in person or by mail with the Counry Auditor of the county where the property is located.
Filing Dates: 1) Real PropeRy: During the 12 months be(ore May 11 0/ tAe year the deduction is to be eNective. �(�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the ye� �tWhe deduc����to� 6eAeffe�tive�
See reverse side for additional instructions and qualifications. " Cf?SON C0� ="v ,i ���?r� !
(otimeror confract buyer - see
Taxing DistriG
��t%✓ '
Assessed value of real property as of
March 1, current year
If no, what is his / her exact share of interest?
Key
Record number
� I�- ba�-9 S rW Page number Q3�
1�
Mortgage / Contract indebtedness unpaid as of Is the applicant t e sole legal or equitable
March 1, current year owner? ❑ Yes ❑ No
� ��
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
�i
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
,\ddress of assignee (numberand st�eef, city, sfate, ZIP code)
Does applicant own property in any other I If yes, what county? I What Taxing Distrid?
county in Indiana?
Deduction approved in the amount of:
�
COUNTY AUDITOR
20 n 20 O� 20
� �
County Auditor
Is the property in question:
❑ Real Property ❑ Mobile Home QC G7.1-�
Has this dedudion been requested on
property for wrrent year?� Yes❑ No
20 0 Y � 20
� P
Date
/ We certify under the penaliy of perjury that Ihe above and foregoing information is true and correct and that the applicants was / were
,°sident of Indiana and owner of the aforementioned property on March 1, 20
Person aulhorized by duly executed Power of Attorney
ar by IC 6-1.1-12-.07
ofauthorized person