HomeMy WebLinkAboutMortgage_Winkfield�ei �' � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
's' : FOR DEDUCTION FROM ASSESSED VALUATION , Coun Township Year
! Siate Fortn 43709 (R615-O6)
Presaibed by Department of loral Govemment Finance
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INSTRUCTIONS: File Mark
To be filed in person o� by mail with the County Auditor of the county whe�e the property is located. DEC 1 4 2001
Filing Dates: 1J Real Property: During the 12 months before June 17 of the year the deduction is to be ectrve. �
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the ye��ue ' is to be effective.
See reverse side loiadditional instnictions and qualifications. � \ G�BSpN COUNTy� �TOR
Applicant
Taxing
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Assessed value of real property as of
March 1, curtent year
If no, what is his / her exact share of interest?
If name on record is different than that of appl
e of mortgagee or wntraIX seller
Addresa of mortgagee or conVact seller (num
Name
� on re�verse side) �
r
number / legal description
c�e.�e i - vic�i
Mortgage / Contred ii
March 1, curtent year
indicate below:
Y(�
Record number
�� Page number
;ss unpaid as of Is the ap�
� owneR
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t the sole legal or equitabie
❑ Yes ❑ No '
If owned wifh someone other lhan spouse, indicate with whom.
��
st2et, aty. state, ZIP
or other owner or holder of mortgage
oi assignee (numoer and sUeet, city, state, ZIP code)
Does applipnt own property in any other I If yes, what counry? I What Taxing Distn
county in Indiana?
approved in the amount of:
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COUNTY AUDITOR
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County Auditor
Is
❑ Real
❑ Mobile Home (IC 61.1-�
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Dra�ver ND.,O,,.(. ..
- �
CaYd �0• ...... . ...... . .
20
Date
, __.: � resLl No
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certify under the penalty of perjury thal the above and foregoing information is true and corred and ihat the applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
ue ners (u a e) Person authorized by duty executed Power of Attomey
�� ����.� � or by IC 6-1.1-12-.07
F�re� ent a�ress,of appli�aN � V � �� �)�,U Address of aulhorized person
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