HomeMy WebLinkAboutMortgage_Spurgeon;e� �"`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
. �� State Fwm 43709 (R6/ 5-06) _
� � Presvibed by Depariment of Lonl Govemmeni Finance �
�-
INSTRUCTIONS: �U�.J O � Ri�`PAa�x
To be (iled in person or by mail with the County Auditor o/!he county whe�e fhe property is located.
Filing Dates: 1) Real Property: Dunng lhe 12 months be%re June 11 of the year the deduction is to be ef(ecGve. ��
2) Mobile Homes assessed under IC 6-1. 7-7: Between January 15 and March 2 ot the yea������duTGoAUp�� effective.
See reverse srde /or additional instn�ctions and qualifrcations. GleSnp� COUN � '
see
Assessed vatue of real properiy as of
March 1, current year
on reverse side)
legal description
b- i a-��s - ao l�a .'Ia�
MoRgage / Contrad indebtedness unpaid as of
March 1, current year
If no, whal is his / her exact share of interest?
If name on record is different than that of applicani, indicate below:
mortgagee or
Address of mortgagee or
�-J
number
; number
I 3 ao
Is the applicant the sole legal or equitable
ownef? �es � No
If owned with someone other than spouse, indicate with whom.
seller
�,� CO
d seller (number and stieet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and st2et, city, state, ZIP code)
Does appiicant own properry in any
county in indiana?
ther If yes, what wunty? What Tax,
� 3 � COUNTY AUDITOR
Deduction appro� ed in the amount of:
20 _Q�(— I 20
P
Signature
20 � 9 20 20
P
County Auditor
Is the property in question:
eal Properly ❑ Mobile Home QC 61.1
l3ao
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C�� _,nis deduqion been requested on
� property for current yea(? � Yes � No
20
Date
�
We certify under the penalty of perjury lhat the above and foregoing information is true and corred and lhal ihe applicants was / were
esidenl of Indiana and owner of the aforementioned property on March 1, 20
name)
Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07
Address of authorized person