HomeMy WebLinkAboutMortgage_Woolstone6'Tn 4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`%'�` � FOR DEDUCTION FROM ASSESSED VALUATION
�y State Form 43709 (R4 / 10-01)
Prescnbe0 by DeOannent of Local Govemment Finance
INSTRUCTIONS:
Count Township Year
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To be filed in person or by mail with the County Auditor oI the county where the p�operty is located. � //
Filing Dates: 1) Real Prope�ty: During the 12 montbs before May 11 of the year the deduction is to be �ctive. ��
2) Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0l the,ye�� �1� pro to-bs c� e.
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See reverse side Ior additional instructions and quali�cations.
Applican wner or contract buyer- see re tricti s on reve e side)
Taxing Distrid Key number / legal description Record number O�
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Assessed value of real property as of Mortgage / Contrect indebtedness unpaid as of Is the applirant the sole legal or equitable
March 1, wrrent year March 1, wrreni year owner? ❑ Yes ❑ No
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Ii 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 lhan that of applicant, indicate below: is the property in question:
❑ Real Property ❑ Mobile Home (IC &1.1-�
me of mortgagee or contract seller
Address of morlgagee or contrect seller (number and st�eet, 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 this dedudion been requested on
county in Indiana? properiy for current year?� Yes❑ No
�� �J ^ � COUNTY AUDITOR
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Deduction approved in the amount of:
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Signature County Audilor Date
�We certify under lhe penalty of perjury that the above and foregoing information is true and correct and ihat the applicants was / were
. a resident of Indiana and owner of the aforementioned propeRy on March 1, 20
Si al (owners (ull name) Person authurized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
Full r ident address of p li nt . Address of authorized person
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