HomeMy WebLinkAboutMortgage_Fetcher"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
�, __ ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fartn 03709 (R71 / 6-09)
S Presaiibed hy Departmem ot tttal Govemmeru Frence
INSTRUCTIONS: 6nrt'fiI
To be filed in person w by mail with the CounryAUditor or Counry Recorder of the oounty where fhe property is located. � l. ��� 2 Q Q9
Ffig Dafes: 1 J Real Property: Musf file durirg the year for which the deduction is soughL � Counry Auditor
2) Mo6ile / Manufactv�ed Homes not assessed as Real Property: Must file dunng [he 1weNe (72) months
befom March 31 0! each year tAe deduction is soughG �❑ Cti4u+ery Recorder
�s.« i�
See reverse side /or additione! instructkxrs end quelficafions.
I Ap t(owner a contracf bu r- see, m reverse side) ^ '
`r N�
IT ' Oistrict Key number! Mgal desaiption Remrd number Page num0er
���nzai� a�o-i3- - oo-ooi. �r� - oo�f oo�J Sr7
As�tsM vahie d mal qoperty as ol Mortgage I Contraa i`MeEteOness unpaid as of Mortgage I Contral inEebtedrress unpaid as d Is Ne appfirant the sole
Mairh 1, anmt year March 7, airteni yrar datc of appGption kgal a epuctade owneY.�
1 / 1 Q /�s n iJ ' ❑ Yes ❑ No
�� Iq. W�12� 6 �16 � i12! EY2f15�12fB 0� Ill}PfPSI:�
�i 1131t18 Ofl IEWI[: 6 dlflPl2f1� 1113f111131 Oi dPP�
Name of mortgagee w mptract seller
/
AOdress W rtnrtqa9ee �mlStrad seAer
Name al astignee a o�er owner or htlEer of rt�ortgage
aaaRSs
sfreec �: sm1e.
cdy, state. elM
Oces eP�cam am properry in any oNer I If yes, what munq?
counryinlnd'ana? � Yes ❑ No
SIXIICOfIC Oil18f b12I15pOLL59.
WAat Ta�drq Distria7
perry in 9uestia�: MnueOy AswsseE
Property ❑MnualyAssesud
Di•a���cr NO.�.R�..�l.-.....
C�CCI�iO...�s�� �
�' / z 9, � oo, ,s�
�