HomeMy WebLinkAboutMortgage_Short (3)'�'�► STATEMENT OF M�RTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R11 / 6-09)
�' prescribed by Departrtrent of Locat Govemment Finance
File Mark
�vsrRUCrroNS: �
To be filed in person or 6y mail with fhe CountyAuditor or County Recorder of fhe county where ihe prope�ty is located.
Filing Dates: 1) Real Property: Must file during the year for whieh the deducfion is sought. � Coun Auditor
2) Mobi►e / Manufactured Homes not assessed as Real Property: Must file during the twelve (f 2) months R��er
6efoie March 31 of each year the deducfion is soughi.
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Deducfion approved in the amount of:
20
Signalure of Couniy Aud'dor
zo I 20
COUNTY AUDiTOR
20
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I I We cefify under the penatty of perjury that the above and foregoing informatio�
owner ! contract buyer of the aforementioned property on date application is filed.
Signature (owners full name) - -
F�11 resident address of a licant (number and street city, state, and ZIP coole)
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Person authorized by duly executed Power of Attomey or by IC 61.1-12-0.7
Address of author¢ed person (number and stree� city, s�te, and ZIP code)
20 � 20 � 20
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