HomeMy WebLinkAboutMortgage_Clark� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION �
:, State Fam 03709 (R71 / 6-09)
��.,� / Presaibe0 q �epartmen� or Lnd Gwemmem Wiar�ce � ��
�� File Mark
INSTRUC710NS:
To be filed in person or by mail wiN fhe CounryAuditor or Counry Recorder o! the county wliere the pioperry is located. F� �� ���
Fifing Dates: 1) Real PropeRy: Must file durirg the year for whicA fha tleduclion is soughL County Audiinr
2) Mo6i7e / Manulactured hbmes rwt assessed as Real Property: Must file dunrrg the hvefve (72) months
6efore March 31 0/ each year Ne deduction is sought. ❑ Cwmty Remrder
Deduction ePP�� in Ne amouN ot . _-
-_ .
�
I / We cerOfy urx
owner / mntrad
0
D ra��� er N O•••?`�`•"' ... ..
598y ....
Card �0' � ioLv�''��• �
��,� � o� �,aY a � �� � ,.,-, z-0.�
Atldr� d eWio�hed persan (numbe� arW sbee4 �: sbfe.
zo � Zo _
��ry �- I��`,�'`�°,� - � D
aUon is We and cartect anA Nat Ne applitant is a resident of IrMiana and
ileE.
Date (month, daY• Y�A
.srv �{ 76 y