HomeMy WebLinkAboutMortgage_Wethington� rt�° � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
e = FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
�, �y State Form 43709 (R4/ 10-01) \
�� PrescriDeO by Departmenl of Loral Govemmem Finance i DULY ENTERED F R TAXATION
�a Subject to final accep
INSTRUCTIONS: � __ day o� — File Mark
To be filed in person or by mail with the County Auditor o/ the county wheie�prop is located.
Filing Dafes: 1) Real Prope�ty: During the 12 months be%re May 11 01 the r the ducfi i to be �
2) Mobile Homes assessed under IC 6-1.1-7: Belween Janua oJ the�F uction is to be ef/ective.
See reverse side /or additional instructions and qualifications. Parcel �
Applicant (owne o contract buyer - see strictions vers ide) •
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Taxing Disirid Key number / legal description Record num ��
�„/� Q I � h .� Page number n��
l.l�' � ' U 'd
Assessed value of real property as of Mortgage / Contract in ebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrrent year March 1, current year ownef� ❑ 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 different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
�e of mortgagee or contreU seller ��'�
✓1
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Address oi mortgagee or contract seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has lhis dedudion been requested on
county in Indiana? property for current year? � Yes � No
COUNTY AUDITOR
Deducfion approved in the amount of:
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Sig lure County Auditor Date
''`Ne certify under the penalry of perjury that the above and foregoing information is true and corred and thal the applicants was / were
� ;idenl of Indiana and owner of he aforementioned property on March 1, 20
Sig e wners lull name) , Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
I resident address of app icant Address of authorized person