HomeMy WebLinkAboutMortgage_Nossett^�� STATEMENT OF MORTGAGE OR CONTRACT INDI
,__ FOR DEDUCTION FROM ASSESSED VALUATION
Sta[a Fortn C3709 (R71 / 609)
�' � Preuribed 6y DepartmerM1 of Lacal GovemrtreN Flnarce
m.
INSTRUCPONS:
�
Coun a i r
L25201
Filg Mark
.'1 f�'�
To be filed in person or by mail with the CountyAuditor or Counry Recorder o/ Ne counry whe2 Ne property is located. Form med w8h:
Filing Dates: 7) Real Property Musl file dunrg fhe year /or which the deduttion is mughL G� O�OISPmYMY+L1�13rOR
2J Mo6Be /ManWactured Homes rwt assessed as Real Properly Must h7e dunrg [he tweNe (72J months
6efae March 31 o/each yea�the deducfion is swghG ❑ County Recwder
See reverse side for additional instruclions and qualifications.
App&�ap� (o1wrreroroontraUb r e n brumreverse� ^ � �._ /�!�
\'�� � 6'CY�I al, a� u S fl0`Y o 3 o'ti S'� O Sh.t
T l e rwmbet / legal desaiption � RecoN numbu Page rwmbrl
� r-.� `���-a�-ba-ab�-�aa.4.��'-oa I ariil ,��1.�5�
:ed vaNe d real ryoperty as of I�L4a9e / Conn
1. amPnl �ear Mar� 1. artent
II no, xfiat Is his / her e�ct share of interest?
If �wrie m remrd is Cifterent Nan Nat af apP��t �dibte below.
„TU�i�TiSiiTl
or oNU owner w hdder of mortgage
Atldress of as9gnee (numbeiaM avee4 �1: state, arM ZIP cotle)
ard
a
ormel?
❑ No
If owned witA sameone dher Nan spouse. ind�te wfih wMm
I5 ihe property in Quer,tim: MnuaDy0.55essed
�eal ProPem' ❑ MnuaII,Y Pssessed
Dces app6raM wm pmperty in any oNa If yes. what counff.+ Wlal Ta�dng DstruY? Has N's tleCUfYion Eeen requested an pmpe+ty I
munry in Indiana? ❑ Yes ❑ No �r W� �n ❑ No
❑ Yes