HomeMy WebLinkAboutMortgage_Kaposta"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
. —.. �• State Fam C3709 (R77 / 6-09) D�
S�.» � PresrnLed M DeCartmeM o(Lawl Goverturerit Wunce 'h�
File Mark
INSTRUCTIONS: ��
Form Aed with:
To be filed in person w by mail wiN Ne County Auditor or County Recorde� of Ne counry wno �e fhe pmperty is located.
Filirg Dates: 7) Real Property: Must file during the year for which Ihe deduction is sought. � Counry Auditor
2) Mobile / Manulactured Homes not assessed as Rea! Pmperty Mus[ fife du„i� the nveHe (72) months
6efo2 Mamh 31 of each year the deduction is sought. ❑ Counb Remrder
See 2verse side for addilional inshucfions arM qualifications.
Applicant( rarmnvaftbuyer-seeres+n�o m versestl ,
Ta�p p��� .�pe I¢g� �� � � y �, Reco�d numbr! Page num6u ,
s.� w.��c
As¢seE va4x af real popeny az ot ge I Gonl
MeiW 1. prrent year Ma 1, airtpert
� O
tl no, what Is his / her exaG share ot inleresK
If name m remN a Cifterent Nan Ihai of appB�nt, i`Minte �ebw
Name of rtnrtgagee or mntract setler
�
Addtess of ce w mntract seller (number aIM street"--" -
Name of assignee w oNer owner or hdEer of mMgage
Pdtlress of asvgnee (numEei eM snee4 �; s+ete, anE LP
Ooes appiimnt own ptoperty in any other It ye
munry in Intliana?
❑ Yes No
DeEurtion appmved in Ne artaunc oE
zo zo zo
sg�n,� w cwn,a nwn� . M.
year
(. ' �O 1 U O
7e / ContrarY indeMeMess �npaid as of Is Ne applkant ihe sole
aGP��^ kgal w�Ie�Wnit"able owneY?
�Tes ❑ No
If owne0 wiM someone ather Ihan spouse. iMirate witli whom
(���yyyy� �C�f �
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C a C (1 �� �.1 . [. . `�/ ;l� ,1,�. . . . . .
V 0 1 lil.�lJ.
COUNTYAUD. �
zo
Caunry
property in Question: MnuaPj Assessed
eal Roper�y Q lvmuaily Assessed
Mod'le Hortie QC 61.7�
6�U�IOfI �2G11�?Qq�y,/g1C4 ql PfOp('llY
�� �r LJ Yes ❑ No
. .: �
zc zo
o� (�nn, ear,
zo
I/ We certify under Ne penalt�j of perjury that Ihe above and (oregoing in(wmaUon is We and corteU arM Nat the applinnt is a resident of Iridiana and
owner! mntrad buyer of Ne afo2mentioned property on date applinlion is filed.
�reoue (o hAlnamel . � ./ .-.� Date (mmN, daY. Y��
��/��i� `L����—�1
���: � �
by IC G7.142�J
Pddress o( auNOraed persa� (numbereM sveef, ciry, stah,
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