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Get State Form 43709 Indiana 2015-2024

STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS FOR DEDUCTION FROM ASSESSED VALUATION County Township Year State Form 43709 R5 / 4-03 Prescribed by Department of Local Government Finance File Mark INSTRUCTIONS To be filed in person or by mail with the County Auditor of the county where the property is located. Filing Dates 1 Real Property During the 12 months before May 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 of the year the deduction is to be effective. See reverse side for additional instructions and qualifications. Applicant owner or contract buyer - see restrictions on reverse side Taxing District Record number Key number / legal description Page number Mortgage / Contract indebtedness unpaid as of March 1 current year Assessed value of real property as of If no what is his / her exact share of interest Is the applicant the sole legal or equitable owner Yes No If owned with someone other than spouse indicate with whom* Is the property in question If name on record is different than that of applicant indicate below Real Property Mobile Home IC 6-1. 1-7 Name of mortgagee or contract seller Address of mortgagee or contract seller number and street city state ZIP Name of assignee or other owner or holder of mortgage Address of assignee number and street city state ZIP code Does applicant own property in any other If yes what county county in Indiana What Taxing District Has this deduction been requested on property for current year Yes No COUNTY AUDITOR Deduction approved in the amount of 20 Signature County Auditor Date I / We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were a resident of Indiana and owner of the aforementioned property on March 1 20. Signature owner s full name Person authorized by duly executed Power of Attorney or by IC 6-1. 1-12-. 07 Full resident address of applicant Address of authorized person RECEIPT FOR FILING STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Name of applicant Date filed Amount of indebtedness Instructions and Qualifications Applicants must be residents of the State of Indiana* Applications must be filed during the periods specified* Once the application is in effect no other filing is necessary unless there is a change in the status of the property of applicant that would affect the deduction* This application may be filed in person or by mail* If mailed the mailing must be postmarked before the last day for filing. Any person who willfully makes a false statement of the facts in applying for this deduction is guilty of the crime of perjury and on the conviction thereof will be punished in the manner provided by law. The deduction equals 3 000 one-half of the assessed value of the property or the balance of the mortgage or contract indebtedness as of the assessment date which ever is least. Authority for signing a deduction application may be delegated only by an executed power of attorney or by IC 6-1. .

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