HomeMy WebLinkAboutMortgage_Euler"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ip vear
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm d3709 (Rit / 6-09) .
1 r Presrribed by DepartmeM o( Lool Govemmanl Frarxe
Fil Mark
wsrRUCnoNS:
Fwm filed with.
To be filed in person w by mail with the CounryAUditor or Counry Recolder o( the county whefe the property is located.
Fdirg Dafes: 1) Real Pmperry: Must file during the year for whirh the deduct'an is sought County Auditw �
2) Mobde / Manu/actured Homes not assessed as Real Property: Must h7e dunng the twelve (ttJ months a /� f!
CSun Re�xder
6etae March 37 0/ each year the deduction is mughG V tY �
See reversa side (oradditmnal insVUCtions and qualifications. G�–"�' ' � DITOR
�/1 iY!/II!//Y ��/ _�� L/! �O21/Y70 e' � `
Key nimber
aarrnt year
11 no. what is ha I her eidtl 5hare o/ interesi?
�-/QJ -Q7 �. �7'�/ -00 / ..........
intract 4Mebtedness unpaid as ot Mongage I CantrafY mCebtedness unpaid as of
�yra�0� dateotappamtion —
Ifc.—'_– .
11 name on ieco�d'e CMerent Nan that of applkant, indicate belmr.
Nartre ot rtrmgagee m m�tracl seller
���
�re.e,�
Name ot assignee w aNef owner or ndtler oi mortgage
AACress at asvgfrea (number aM street, r4y, sfafe, and ZIP caCe)
Ooes epplifant ovm yoperty in any ot�er tt yes, what
munry in Indiana?
❑ Yes ❑ No
�tNw �,�-3-9�
Detluc6rn app�w�.W in the amount at
2q 20 20
Page number �
��J
Is the appli�snt the sde
legal w eWitade ameR
— -�r] Yes ❑ No
Dra���ci• NO..c?ZOO�......... Y��
3$8�f �
CaC(1 NO . .....................
��3��
nuortorx
20 � 20 _
Caunry
Has Uris tledurlion Eeen re9uested on propeM1y
for artent yeaR ❑ Y�
❑ No
20 I 20
1/ We cert'rfy under ihe penalry of perjury that Ne above arW toregoing infortnalion is we and corte�Y arM that Ne appiicant is a resident t
owner I contraIX buyer of [he aforemerrtioned pmperty on date application is filed.
s�q�(owne.s � name) ^ `'C� � o-ete (,m+,m, aar. ree�
.�� �
C�
Full�mss of appfi�ant (numberantl sbee4 dry, state, antl LP wde)
>c Inc�SS s s,� s� � fhP.{�f�� .i � �f��13
Persq� au0pr¢ed by duty esecuted Power d Ativney w by IC 61.1-12-0.7 Date (mmN. daY. Y��
Addmss ot authorrzed person (numDe� arM street, pry, stata,
arM