HomeMy WebLinkAboutMortgage_DuncanR'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
__ FOR DEDUCTION FROM ASSESSED VALUATION
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� File Mark
INSTRUCTIONS:
fi 6e fiied in person w by mail with the CounryAUditor or Counry Recordar o/ the counry wMrc tf+e pope�y ted. F� ���
Filhg Dates: i) Real Property: Must file durrrg the year lor which the deduction is soughL U t�� 1 L�� �unly Auditor
2) Mo6Je /Manulactuied Homes not assessed es Real Pmperty Must file dunng the hveHe (12J rtanths ❑
before Maich 31 0l each ysar the deduclion is sought �^b R��
See reverse si0e for eddifiunal instructbns and qualifications. �G� ��
AppGnn�(mmerar 6uye -^earesbicf�uam sde) � a OIBSON C,0 HTY hUp!TpF
� vawe ar mai prapaty az m gg�(pot
M�Ch 1. aimY year Me t,ak�(
n no. what 6 nis � her e� s�ara m inrem3t?
tt �urte m rema e dAfumt than that ot aGP��. cM"vate Geb�r.
Name of rtnrtgagee m m�trarl seller
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AOdress d rtnm7agee ar cantraU sn�er (number ard c�N. z
Name of av�ee or other awner w hddel of mortgage
PilE�ess at a�rree (number aM sbeet �l: s+ete. arM LP cade)
Does epptifant own pnperty in any oNer If yes, whx
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I I We certify under �he
owner / contracl buyer
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20_
dob �-oo/ J .w_._.�at
Mart9a9e I Cantra�Y iMehtetlness un7aid as of Is ihe eCd�t tha mb
data of aAP��+ kgal a ewileble an1mY1
❑ Yes ❑ Nn
If owned with sarea�e othg than spouse. IM�ca[e with wtarn
IS fFM P�G�Y fll G����: ��eOY �
❑ Real PtoxrtY ❑ ai?n!a�h Ps�essed
code)
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p U �CfW -TAG O6 A�D,��
�v�o-yaoS
y of perjury that Ne aDOVe and roregomy nnu ��e�,... �., .. __ _.._ __.. __.
aforementloned Droperty wi date appliration is filad.
(number antl stree4 dry, s7a1e, end LP mtla)
M/ Ctdy erecuted Porer Mnmrney « Cy
arM ZIP cade)
im Daen requested m pmpaty
❑ ves ❑ No
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,m,W. Eay 1'��
,�t is a residerrt ot Indiara and
Date (rtv�Ci. deY. Y��
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