HomeMy WebLinkAboutMortgage_Wright Living Trust'� ��.
�i � STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
u. J State Form 43709 (R6l SO6)
� Presrn6ed by Department of Loral Gwemment Finance
INSTRUCTIONS:
To be filed in person or by mail with the Counfy Auditor o! the county where the property is
Filing Dates: i) Rea/ Property: Dunng the 12 months before ,lune Il of the year the deduction is to be e�Q �e0 6 2�� �
2J Mo6ile Homes assessed unde� IC 6-7.1-7: Between January 15 and March 2 of the yearThe deducG'on is to be elfective.
See reverse side for additional instnictions and qualifrcations. �-�7 �
!/"`6� � �
_ . ,. ��uTV AUDIT�R
Applicant (owner
Taxing Distrid
n �,
6uyer- see resM n�on reverse
� ' -
Assessed value ofrealproperty as of
March 1, current year
If no, what is his / her exact share ot interest?
Key number(I�gal description
number
� ��D�_ ����• IPagenumber ��nb
•Ya
Mortgage / Conlrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year owneR ❑ Yes ❑ No
3�� -
If owned with someone other than spouse, indicate with whom.
If name on record is different lhan that of applicant, indicate below:
�me of mortgagee or contrad seller
`��� �
Address of moAgagee or contrect seller (number and stre ity, state, ZIP
of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appiicant own property in any other If yes, what /�/�� ,?
county in indiana? � V �/ �._ � S O�
Deduction approred in the amount of:
20 _�� 20 �_ 20 Q'
\ � �
Signature
�
County Auditor
20
Isthe propertyin queslion:
❑ Real Property ❑ Mobile Horne pC 61.
Has this dedudion been requested on
property for current yea(? � Yes ❑ No
20
Date
20
��/ We certify under the penalty of perjury that the above and foregoing information is true and corred and lhat the applicants was / were
resident of Indiana and owner of lhe aforemenlioned property on March t, 20
��' ignature (ownels (ull name) .% Person authorized by duly executed Power oT Attomey
� � � � /. 1 / _ 1 . _ � �. A or by IC 6-1.1-12-.07
person