HomeMy WebLinkAboutMortgage_Walker (8)���� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION
's� / SUte Fortn 43709 (R6 / 5-06)
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� Presaibed by Department of Laal Gwemment Finance
INSTRUCTIONS: � T � �il Ma
To be fiied in person or by mail wdh the County Auditoi of the county where the property is l�ated.g
Filing Dates: 1) Real Property: During the 12 months before ,lune I1 of the year the deduction is to be elfective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of fheiy�� th� �e��n is to be effective.
See �everse side for additional instrucGons and qual�cations.
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Applicant (ownerorcont2ct buyer-see �estri tions o �eve�se side) OIBSON COUNTY AUDITOR
Taxing District Key number egal description Record number
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V' �' �o o.Ob Page number G/
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Assessed value of real property as of MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March t, current year owner? Q Yes � No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is dif(erent than that of applicant, indicate below: Is the property in question:
❑ Real Property O Moble Fbme QC 61.1-�
��me of mortgagee or contrac er
Address of mortgagee or contract seller (numb r and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, Z1P code)
Does applicant own property in any other If yes, what county? What Taxing District? Has this deducdon been requested on
wunty in Indiana? property for current year? QYes❑ No
COUNTY AUDITOR
Deduction approved in the amount oi:
20 20Q� 20 Oq 20 20 20 20
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Signature County Auditor Date
.I / We certify under the penalty of perjury that the above and foregoing infortnation is true and cortect and that the appticants was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20 .
yr�ature wners full na e) — Person aufhorized by duly executed Power of Attomey
y� or by IC 6-1.1-12-.07
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Full resident ss of applicant Address of authorized person
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