HomeMy WebLinkAboutMortgage_Beasley�. °—^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS � To 'p � Year
s'. •
• FOR DEDUCTION FROM ASSESSED VALUATION
Slate Form 43709 (RS / 2-07)
'';- •� Resaibed by Department of Local Govemmeni Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail wdh the CountyAuditor o! the county wbere fhe property is located. - �� ,Q��
Fi/ing Dates: 7J Real Property: Dunng the 72 months before June 11 0/ fhe year fhe deduc6on is to be eRecfive.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year fhe deduct(g(g'$m�p�yp� AU�ITOR
See reverse side foi additional insWcUOns arrd qualifreations.
buyer - see reshic(ions on reverse side)
Key number�/ legal descn�i6n // Reco�d number
�yc-d - 3 - �� /o ,3 -000. o - b os-- � 0 8
real property as d March 1, cunent year Morigage I ConUaa indebtedness unpaid as W March 1, Is Ihe applipnt the sWe I[
artentyear .
a- / (J /� O
what is his / her exacl share of iMeresl?
name on recwd is differenl Ihan �hal
orcanUact
Adtlress of moM1gagee w mnlract seller (number antl sY+eef, oty, s}afe, aM ZIP code)
Name of assignee w other owrrer or holder of mortgape
Atldress of asvgrree (rnmbei aM sVeet.
someone
operty in any other If yes, whal counryT I VJhat Tening Disiricl?
❑ Yes ❑ No
Deduction approved in Ihe amoun� of:
20
SignaWre of C6unryAUdibr
20
(5
❑Yes ❑ No
Is Ihe property in question:
❑ Rral Pmperty ❑ Mobile Home (IC 61.
Drawer N� .W..6."5���
Card NO. .............
COUNTYAUDROR � - ������
al�400: °o
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Counry
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I/ We certify under the penalry of perjury that tlie above and fwegoing infortnabon is We and correct and fhat the applinnts was ! were a resident of
Indiana and owner of the afwementirned property on March 7, 20
7nawre (o eYS lull name) - D� (�N. �Y. Y��
.�1.� . �- 0_ /2_ �i_�Q
address of applicant
Address af aulM¢ed person
md street. cifv/slate. arM ZIP mtle)
� J�iP/.f q/ L� s c
af Ntaney or by IC 61.142-.07
'street dty. sfele. and LP mtle)
oare �r�,mm. aar. r��