HomeMy WebLinkAboutMortgage_Seib.¢ "'^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
r FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fortn 43709 (RS / 2-07)
�' �� Presrnbed by Department of Local Govemmenl Finance
File Mark
INS7RUCTIONS:
To be filed in person or by marl wdh the CountyAuditor of the county where the pmperfy is located. �
Fd'mg Dates: 1J Real PropeAy: Dunng the 72 months be%re June 17 of the year the deducUon is to be eftec6ve.
2) Mobile Homes assessed under IC 61.7-7_ Behveen January 15 and Ma/ch 2 o/the year the deducU � to b e8 6ve. �
See reverse sidela additional inshuctions and qualificafions. ��
Applicant(owner 6uyer-seeresfrictrons 2ve � QQ�
�9 .� �..,�.���a .n_ �_�_,� � _,;
i,
/ her ezacl share of inlemst?
If reme on �ecord is dittcrent ihan thal of applicant,
Name of moriga9ee ar ca�iracl seller
Address of mortgagee w cmUad seller (number aM street.
Name of asagnee a Wher owner or hdder of mw�gage
Address of assigriee (numbei aM sGeel, city, state, and LF
Daes applicant own (xoperty in arry oU�er
caunry in Indiana7
❑Yes ❑ No
Deduction approved in �he amaunl of:
1 J. QI�- i�
Morigage I
wrren� vez
whatcounty?
�,-OD3. 3 �lu-o a
indeWedr�ess unpaid as of March 1,
What Tazir
COUNTY AUDITOR
20
I ❑ Yes ❑ No
sameone olher ihan spouse, irMicate wilh whom.
Is �he popeM1y in question:
o. Real Pmcenv ❑ Mobi�e t+«„e nc s,
20
�����" ' s- a S�. � Y
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ijii• r
, 90 00�.,� oa�rn
�
aoo8- 3roc� ] N�
20
20
imWre o{CounryAudM1Or Counry I Date (maiN, tlay, yea�
I I We certify under the penalty of perjury that the above and foregoing in(ortnation is We and cortecf and that Ne applicants was I were a resident of
In�a and owner oSJhe aforemen6oned orooerty on March 1, 20
nirelowne. lna / Date(nxnlh.daRY�d
Address of auUmr¢etl person
nd sG�el. city. . fe. ZIP m
N Attaney w by IC 67.142-.07
stree( dty, stafe, arM ZIP wde)
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