HomeMy WebLinkAboutMortgage_Clanton�
STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
• FOR DEDUCTION FROM ASSESSED VALUATION
�'. ♦ Sfate Fwm 43709 (R5 / d-03)
•�
� PmsaiDaO Ey Departmant of loral Govemment Finance
INSTRUCTIONS:
To 6e filed in person or by mail with the County Auditor of the county whe2 the property is locafed.
Fiiing Dates: 1) Real Property: During the 12 months belore May 11 0/ the year the deduction is to be eflective. N O V U� ���3
2) Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be e(lective.
See reverse side for additronal instructions and qualificatrons. � ;`� n� t
� l� -i 3-►3 - 3 C�G c�a I(�-1=00 l� ���so�J��',,,;.: ;�.1 �
� Applica t(o er or co�fract buyer - see restnctionp� reverse side) „ n
Taxing Dislrict D
c -
Assessed value of real property as of
March 7, current year
� �
Key nu er / legal description Record number
, . ��-a-,��
no, what is his / her exact share of interest?
Page number
3-c>o I b1- �
Mortgage / Contract indebtedness unpaid as of Is the applicant t s egal or equitab�e
March 1, curtenl year owner? es ❑ No
If owned with someone other than spouse, indicate with whom.
If name on record is different than that of applicant,
of mortgagee or contract
Address of mortgagee or contrect seller (number and street, city, state,
Name of assignee or other owner or holder of mortgage
Address of assignee (numbe� and street,
Does applicant ovm property in any
county in Indiana?
Deduction approved in the amount of:
state,
If yes, what ^�-
20 ,2� � zo � � zo o� � za _�
County Auditor
in question:
y ❑ Mobile Home (IC Cr1.
i
� - .���K ��� —
1�;� G� y a.� � � �''''
U
l�}a��'e �# a$ � f �p� f1-��_ o�
�a� �le�aoss ��J�^' r�'nr.�U`L.LJYes�No
gank `� a
za �_ zo �_ zo
P P
Date
certify under the penalty of perjury that the above and foregoing infortnation is true and corcect and that the applicants was / were
ient of Indiana and owner of the aforementioned property on March 1, 20
resident address of
c � � �..�;
by IC 6-1.1-12-.07
, � IAddress ofauthorized person
---------------------=-------------------------