HomeMy WebLinkAboutMortgage_McCray (2) A, OR DEDUCTION STATEMENT IO OF F MORTGAGE ES OR CONTRACT INDEBTEDNESS County �opnshit L r
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FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709(R11/6-09)•
"� Prescribed by Department of Loral Government Finance
INSTRUCTIONS: as I
Foam filed with:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. 7 • in •••
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months I-7 � jjq►1�j;
before March 31 of each year the deduction is sought. - GIB`•N •UNT AUDITOR
See reverse side for additional instructions and qualifications.
Appfrante can y on nor e l
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Key.f. /legal descriptor Record number P e rum
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R��s i value of real property as of Mortgage/Contact indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the applicant the sale
Mardi 1,arrant year Match 1,current year date of appfxation legal or equitable Amer?
Jo 3 its ❑ Yes ❑ No
If no,what is N than-spouse,
s I her exact share of interest? If owned with someone other Indicate with whom
If name on record is different than that of applicant.indicate below ��` Is the property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller /a i1 /)
Address of mortgagee or contact seller(number and street,city,state.and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code) Jn
Does applicant own property in any other If yes what county? • What Taxing District? Has this deduction been requested on property
county in Indiana? ❑ Yes ❑ No for current yeah ❑ Yes ❑ No
IC - Q, COUNTY AUDITOR
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Card a)"(1 O. (40.128•� County Date(month,day,year)
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I/eve tx try as rue, a m',anal.,v vcr•r wa.-•...w••--•-•-•.going information is true and correct and that the applicant is a resident of Indiana and
comer I contract buyer of the aforementioned property on date application is filed.
Signature owner's MI name) Date(month,day,year)
Full resident address of applicant(number and city state,and ZIP code)
<O 2 S S. ;2'- // � ' ST Our/e/v5 I,((ig. /v 1-/71061
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorised person (number and street,city,state,and ZIP code) .