HomeMy WebLinkAboutMortgage_Easton �.a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
kFci��tt���� FOR DEDUCTION FROM ASSESSED VALUATION
1 State Form 43709(R11/6-09)
CI Prescribed by Department of Local Government Finance Ft
File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. • - -•I
Filing Dates: 1) Real Property:Must file during the year for which The deduction is sought. 9 County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must Re during the twelve(12)months
- before March 31 of each year the deduction is sought. I l h, �ecorder
See reverse side for additional instructions and qualifications.
GIBS* • it ITOR
Appfoant(owner or contract buyer-see restrictions on reverse side)
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Ta istrrl Key number/legal description Record nun P number
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Assessed value of real lropety as of Mortgage/Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the approant the sole
March 1,current year March 1,anent year date of appgcation legal or equitable owner?
1 \ 0 C\0 Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than sparse,indicate with whom
If name on record S different than that of apWoant,indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
• Mobile Home QC 61.1-7)
Name of nlort cg@gee or contrail seller
seller
Address of mortgagee or contract seller(number and meet.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)
Does applicant own property in any other If yes,what county? • What Taring District? Has this dedumon been requested on property
county in Indiana? ❑ current❑ No for cuent year?
❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved In the amount at.
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/contract buyer of the aforementioned property on date application is filed.
Signature( nom ) Date(month,day.year)
Full resid ad of appG t( umbarand t My,state,and ZIP code)
Pessc 4 authorized by duly executed Power of Attorney or by IC 6-t-1-12-0.7 Date(month,day,year)
Address of authorized person (number and meet dry,state,and ZIP code) _