HomeMy WebLinkAboutMortgage_Wolfe (3)���
��
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (R6 / 5-05) �
Resaibed by �epanment of Lral Govemment Finance
Count Township Year
INSTRUCTIONS: File Mark
To be filed in pe�son o� by mail with the County Audito� of the county where the propeRy is located.
Filing Dafes: 1) Real Property: Dudng the 12 months 6efo2 ,lune 11 0/ the year fhe deducti is to�N liv
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 a��h ( the ear f d uction is to be effective.
Shee reverse side lor additional instructions and qual�cations. jl. ,
lnn ..�1�20��
(owner or contrdc,(buyer, see restric[ions on reverse
value of real property as of
March 1, wrrent year
16no, what is his / her exact
� �r� �� .
nu�p er le I description � R� i.tIl1in � Q
��v-Id-� -�/03�GY�3•52��° .
�' �_ O�� n( yOO � Page number •� n S(�
/ \/ �� �
Mortgage / Contract indebtedness unpaid as of Is ihe applipnt the sole legal or
March 1, wrrent year ownef? ❑ Yes ❑ No
If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
Address of mortgagee or conVad seller (number and
Name of assignee or other owner or holder of mortgage
Address of assignee (number and streef, city, state, ZIP code)
Does appliwnt own
county in Indiana?
Deduction approve
� �71
/
Signature
in
If yes, what county?
�^' • �
� ��aG�7- / 8 �
--L
�������� . o a
20 � 20 I 20 _
P
County Auditor
If owned with someone other than spouse, indicate with whom.
Taxing Distrid?
AUDITOR
20
❑ Real
❑ Mobile Home (IC 61.
Has this deduction been requested on
property for wrrenl yeaR�] Yes❑ No
20
20
' We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was �/ were
resident of Indiana and owner of the aforementioned property on March t, 20
Person aulhorized by duly executed
or by IC 6-1.1-12-.07
Address of authorized person
N