HomeMy WebLinkAboutMortgage_Watkins (3) CT FORD DUC ION FROM ASSES ED VALUA ION BTEDNESS County Township Year
dr,--.1.,atit.:, STATEMENT OF MORTGAGE OR.ittfil State Form 43709(R11/609)
Prescribed by Department of local Government Finance
File Mark
INSTRUCTIONS:
F' fit:.1 .
7b be filed in person or by mail with the County Auditor w County Recorder of the county where the property is boat ' •
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. j wi . i. >Aitor
2) Mobile/Manufactured Homes not assessed as Real Property Must Me during the twelve(12)mon
before March 31 of each year the deduction is sought ❑ County Recorder
See reverse side for additional instructions and qualifications. M' i
Appfiant(• buyer-see resuictnns on - - side) n
►= : , _ + SI. S•_. 0 fa ALP tail i i
Taxing District I Key`2tuber/ al desciP ci1%:e,."i'%mt a number
I �Y(/.- . '- 3Cb2- c03. 698-nom a GIB-ON, S • NTY •U I .14.
Assessed value of real property as of I Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the appll ant the sole
Math 1,current year I March 1,crust year date of application legal or equitable owner?
r ❑ Yes ❑ No
If no,what is his I her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of appicnt,indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
. Mobile Home QC 61.1-7)
Name of mortgagee or contract seller S/3
Address of mortgagee or contract seller(number and street.city,slate,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street city,state,and ZIP code)
Does applicant own property in any other I If yes,what county? - What Taxing District? Has this deducton been requested on property -
munty in Indiana? ID Yes El No for Q1Oef"'�n ❑ Yes ❑ No -
COUNTY AUDITOR
Deduction approved in the amount of.
20_ 20 20_ 20 20 20 20
Signature of County Auditor • County Date(month,day,year)
I I We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
Sig <, -(o ... full ) Date(month,day,year)
'f,JyA--
07,//loi3 .
andxapp (num and street ally,state.and ZIP code)
Pi .. :waged by duly executed Power of Attorney or by IC 61.1-12-0.7 Date(month,day,year)
Address of awwrvsd person (number and street.city,stale,and ZIP code) .