HomeMy WebLinkAboutMortgage_Englehardt�,�"� . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
- FOR DEDUCTION FROM ASSESSED VALUATION ��
a: -r
S1ate Form 43709 (R8 / 2-07)
�9 ' '�, Presrnbed by Depariment of Local Govemment Fire�e
wsrnucnoNS: AUG 2 2 2��Mad`
To be fi(ed in person or by mad wdh the CourrtyAuditor o/ the county where the pmperty is located.
F�ing Dates: 1) Real Property� Dunng the 72 months before June 11 0/ the year lhe deduttion is to be eflective. ��/��
2) Mobile Homes assessed undei IC Gl.l-7: Behveen January 15 and March 2 o(the year the deduc��gl�of b�¢&ve.
See 2verse side (a additional instructions and quali(catioru. t� U
ON COUNTY AUDITOR
Apdirant(orm or fradbwc�-seei��.tialsonreverseside) /y /y � A — .
�OisUiq Key number / legal tlesaiption Remrtl numDet
; -ab-o -�o/- .o -c�
setl value of real property as af MarU 1, arreril y�r Mortgage / CoMract intleWedness unpaid as of March 1, is Ihe appticanl lhe sde legal
artent year
QO
what is his / her erad share of irrterest? I( owned wiih sameone olher Ihan spouse, �wte wiih whom.
If rame on recwa
Address of rtartgagee or oonlraC seller (num6er aiW street dry,
Name of assignee or olher ow�r or hdder of mortgage
Address of assignee
Deduction
20
SgraWre of Counrylwditor
a�y
0
No
and
If yes, what count�?
20 _
What Tauing Di
TY AU�
20 20
County
I���f.'
P��M in question:
al P�opeM ❑ Mobile Home QC Gt.
Drawer NO. �.�%.:. � 5'�3
CardNO . ..................... �m
� No
20
20
I I We certily under the penalry of perjury that the above and (oreqoing infortnation is We and cortect and that the applicants was / were a resident of
Indiana and ovmer of the atorementioned property on March 7, 20 _
ot applicanl
exewted Power
Address of authonzed persm (numbe� and sLeet
cily.
IC G7.
S
Date (monN, day, yea�
,lle s�. '
Date (monN, day, yea�