HomeMy WebLinkAboutMortgage_Young (14)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
, �� ! State Form 63709 (RS / 4-03)
� PrasaiDed by Depanment of Local Govemment Finance
INSTRUCTIONS:
Coun Township Year
File Mark
To be filed in person or 6y mail with the County Auditor of the county where the property is located.
Filing Dates: 1J Real Property: Dunng the 12 mon[hs before May 11 0/ the_ year-the deduction is to be eHective.
2) Mobile Homes assessed under IC 6-1.1 �7:.8etc�een Janu'�5 � nd Ma�ch 2 0l the year the deduction is to 6e effective.
See reverse side lor additional instructions and qualifica � s. �� ���
4 20��
Applicant (owneror ntract buye�- see restnctions on revers i e)
�F �' S. � �� � �
Tauing Distrid Key numtierA�tegal'de.; pti'onhvC"� Record number �
/ ` G;3SG�' ,
�j„^ Q I n_ `� ^O _OU Page number �O
w.. "� s �,
Assessed vatue of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
V `�
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 difterent than that of applicanl, indicate below: Is the property in question:
❑ Real PropeAy ❑ Mohile Home (IC 61.1-�
�me of mortgagee or contraIX seller �' �
Address ot mortgagee or contract seiler (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage '
Address of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any olher If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for wrrent yea�� Yes� No
COUNTY AUDITOR
Deduction approved in the amounl of:
20 20 Q�; 20 � 20 � 20 �_ 20 20
p � P P
Signature Counry Auditor Date
� We certify un er the penalty of perjury that the above and (oregoing infortnation is true and corred and that the applicants was / were
resident of I iana and owner of the aforementioned property on March 1, 20
Sig fure (o ners /ull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
II sid t addre s of app icant Address of authorized person
S' (� �u?b?