HomeMy WebLinkAboutMortgage_Robling (2)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Townshi Year
� Stste Form 43709 (RS / 4-03) � � �
� PrescriEed by Department of Lccal Govemment Finante �
iNSrRUCnoNS: .1AN 0 4 ���e�
To be filed in person or 6y mail with the CountyAuditor of the county where the propeRy is located.
Filing Dafes: 1 J Real Property: During the 12 months be%re May 11 0/ the year the deduction is to 6
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Ma�ch 2 oL�rye�year f dedu�n is to 6e eHective.
C31850N COUNTY AU61fi6A
See reverse side lor additional instructions and qualifications.
or contract
/ i�L�O �-/
Assessed value of real property as of
March 1, current year
� ��� /`7�_ ��
If name record is different than that of appti
of mortgagee or contrad
Address ot moRgagee or contrad seller
on
Key number / legal
Record number
�/Q O� S�� (fv Pagenumber
� or
MoRgage / ContraG indebtedness unpaid as of Is ihe applicant the sole legal or equitable
March 1, cunent year —^ �7`i/�v owneR ❑ Yes ❑ No
d7 �r
��
d
below:
If owned with someone other than spouse, indicate with whom.
and st�eet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et,
Dces applicant own property in any
county in Indiana?
Deduction approved in the amount of:
20
Signature
� r:
�
s the property in question:
❑ Real Property ❑ Modle Home QC 61.
'�OQ(.AG
A�� �
aty, state, ZIP code)
If yes, what county4 What'
COUNTY AUDITOR
20 O � 20 20
�
County Audilor
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�
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Pl �� ��O �sted on
V � r�.,yc� ry ror wrrent yeart L) Yes ❑ No
20
Date
20
We certify under the penalty of perjury that the abave and foregoing informatlon is true and corred and that lhe applicants was / were
resident of Indiana and owner of the aforementioned propeRy on March 1, 20
of
or by IC 6-1.1-12-.07
of authorized person