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HomeMy WebLinkAboutMortgage_Lloyd (2) r . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year _''°?�!- FOR DEDUCTION FROM ASSESSED VALUATION H A State Form 43709(RS/2-07) A�,�i/Q •,,ieu j Prescribed by Department of Local Government Finance INSTRUCTIONS: SEP 110 $ To be filed in person or by marl with the CountyAuditor of the county where the property is located. Filing Dates: 1)Real Property:During the 12 months before June 11 of the year the deduction is to be effective. 2)Mobile Homes assessed under IC 6-1.1-7:Between January 15 and March 2^"' ?yen-" }deduction is`t jm fecf See reverse side for additional instructions and qualifications. O�� `U CIBSON f'OIINTY AUDITOR Appr ft(owner or buyer!e(ostrich ns n reverse side) Taxi Istria Key number�ption Record number Page number �' � — alv oN � 5' 3O3 - 000. Jcc ouzo Xoo8 y50o Assessed value of real property as of March 1.anent year Mortgage/Contract indebtedness unpaid as of March 1, Is the applicant the sole legal or equitable owner? anent year 330 o0 , _ Yes • No 410,what is his/her exact share of interest? If owned with someone other than s'•use,indicate wi r whom. r( If name on record is different than that of applicant,indicate below: Is the property in question: ❑Real Property ❑Mobile Home(IC 6-1.1-7) Name of mortgagee or tract seller - Name of assignee or owner or holder of er and street,dry,slate.and ZIP code) fmortgage Drawer NO...n'$.. Address of assignee(number and street.city state.and ZIP code) 1 500 Card NO. ..../.ylJ.y.... , Does applicant own property in any other If yes,what county? What 41 33,l.t.. • xi on property county in Indana? ❑yes 0 N y^^ I Ili Yes 0 N COUNTY AUDITOR y �1 il-da ( Cot 0 e -(46 7/ Deduction approved in the amount of: / _ Q �+ 20 0 9 20 20 20 20 20 _ 20 Signature of County Auditor County Date(month,day,year) I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was I were a resident of Indian- and owner of the aforementioned roperty on March 1,20 . Signature •\er's MI })-r:\/X/} I Date(month,day.year) il�tJ le? `' sidenl of�w Ica number and street,cdy. t . ,ZIP fie') 1 .r .s o) 7e1,1 rLdvPl�. „pate jAa lio. y7_/ /4 Attorney authorized by duly exearted Power of Attorey or by IC 6-1.1-12-.07 Date(month,day year) Address of authorized person (number and street.city.state,and ZIP code)