HomeMy WebLinkAboutMortgage_WadeN �1
/e�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
1\i��r FOR DEDUCTION FROM ASSESSED VALUATION ount Tm.vnship Year
`•; ... «• . J State Fwm 43709 (R6 I 5-06)
:� Presaibed by Depariment of Local 6wemment Finance
JUN 0 8�007
INSTRUCTfONS: File arlc
To be filed in person or 6y mail with the Counly Auditor of !he county whe�e lhe property is located. �,,
Filing Dates: 1) Rea( PropeRy: Dunng the 12 months belore ,lune Il of the year the deduction is to be elfecffve.q .Q/.%, .
2)�Mobile Homes assessed under IC 6-1.1J: Belween January 15 and March 2 of the y8��i���'�i��v��ective.
See reverse side foi additiona/ instaictions and quali(rcations.
Applicanl (owner or contrac_ _ __. -.
Taxing
�e
Key number / legal description � Record number
� a - a- � �3-000, g�y �
Assessed value of real property as of MoRga e/ Contrad indebtedness unpaid as of Is the applicant the sole legal or e
March i, current year March 1, rrent year ownef? ❑ Yes ❑ No
�OC • JW
If no, what is his / her exact share of interesi? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
�me of mortgagee or contract seller �
%' ��. �
Address of mortgagee or contrad seller (number and street, city,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP
Dces applicant own property in any other If yes, what wunty?
county in Indiana?
Deduction appro� ed in the amount of:
20
e
Signature
� • 7
ZIP
What Taxing Distrid?
COUNTY AUDITOR
20 0 9 20 20
P
County Auditor
O Real PropeAV ❑ Mobile Home OC G1.
Has this dedudion been requested on
property for current yeaf�� Yes❑ No
20
Date
20
We certity under the penalty of perjury that the above and foregoing infortnation is true and corred and lhat the applicanls was / were
re;ident of Indiana and owner of the aforementioned property on March t, 20
(owners full name)
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person