Fulton County Auditor
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STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (R13 / 10-15)
Prescribed by Department of Local Government Finance
To be filed in person or by mail.
1) Real Property: Must be completed and dated in the calendar year for which the deduction is sought. Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is located on or before January 5 of the immediately succeeding calendar year.
2) Mobile / Manufactured Homes not assessed as Real Property: Must file with the County Auditor of the county where the property is located during the twelve (12) months before March 31 of each year the deduction is sought.
Form filed with:
for additional instructions and qualifications.
Applicant Name (Last, First)
Key number / legal description
Assessed value of real property as of assessment date, current year
Mortgage / Contract indebtedness unpaid as of assessment date, current year
Mortgage / Contract indebtedness unpaid as of date of application
Is the applicant the sole legal or equitable owner?
If no, what is his / her exact share of interest?
If owned with someone other than spouse, indicate with whom
If name on record is different than that of applicant, indicate below:
Is the property in question: Annually Assessed
Annually Assessed Mobile Home (IC 6-1.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract 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)
Does applicant own property in any other county in Indiana?
If yes, what county?
What Taxing District?
Has this deduction been requested on property for the current year
If yes, state amount of deduction
A person is not entitled to this deduction unless the person has a balance on the persons mortgage or contract indebtedness that is recorded in the county recorders office (including any home equity line of credit that is recorded in the county recorders office) that is the basis for the deduction.
Deduction approved in the amount of:
Signature of County Auditor
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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.
Full resident address of applicant (number and street, city, state, and ZIP code)
Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7
Address of authorized person (number and street, city, state, and ZIP code)
Address off mortgaged property
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed $10,000.
Signature (owner's full name)
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