HomeMy WebLinkAboutMortgage_Heavrin.a °^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
• �� �
Slate Form 43709 (R8 / 2-07)
�' P' Presuibed by Depanment M Lacal Govemment Finance
File Mark
�NSrnucnoNS: OCT 1 5 2008
To be lled in person or by mad with the CouNyAuditor o/ the courrty whe(a fhe piopeity is bcated.
Fd'mg Dates: 1) Real Property: Dunng the 12 months befwre June 11 d fhe yrear the deduc6on is to be effective.
2) Mobile Homes assessed,a/der IC 61. iJ: 8elween January 15 and March 2 of the year the deductim is to 6e efleGfiyg� ��
See reverse side (or additional instructions arrd quaG�cations. 0��
ApplicaM roqmnVadj�vyer-seere�plSMlBV�I�9dB� . / r .
ralue ot real
I If �me m
is h's I her erad
or canU-acf sdler
� Address of mortga9ee a oonUacl seller
� Nama of assgnee a dher owne+ a
I Address
praparty in arry dher
❑Yes ❑ No
� oeduclion aav�wed in Ilie
�
_/
1 i. 4lICN y02I MM(�gC � r.0�
arte,rt year /
at?
applicanL indiqte belaw:
ium�� fe,�
� d malgage
dty. state. antl LP aode)
It yes. what tamf/1
20 I 20
unpaid a5 of MarU 1, � Is �he appfimnt Ihe sde
If wvned wilh mrtreone
Ta�dng Disiricll
20 _
SigreWreafCounryAud"Anr I ' ���Y
i/ We cerUfy under the penalry of perjury that the above and foregoing infomiation is trve and correct a
Indiana and owner of the aforementioned property on March 7, 20
/ Sig e (owne(s /ufl name) � '
I �
F addrass of appiiranl (number and street aty. slate, and LP ootle)
� S3 S E 'h S� e � �(
Person aulhorized bY tluly exeai(ed Power of Ntorrrey w by IC 61.7-72-.07
au�hor¢edpersa� (numberandstreet.
❑ Yes ❑ No
spouse,
Is Ihe property in questim:
❑ Real Property ❑ Mobile Horne QC 6-1.
Has UJs deduclion been requesletl on property
far artenl yea(/
❑Yes ❑ No
Drawer NO... °���..` ...
Card NO. ...��.�........
Date (mmN, day, yeaQ