HomeMy WebLinkAboutMortgage_Julian^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ � FOR DEDUCTION FROM ASSESSED VACUATION
Stata Fortn 03709 (R71 / 609)
� ! Presaibed Dy DeVartrnent of Lncal GovemmeN Finance
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wsrRUCnoNS:
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To 6e filed in person or by mail wiN the County Auditor or Counry Recnlder of the county where the pioperty is located. 2 � 11
Filirg Dates: 7) Real PropeAy: Must file durirg Ne year (or whicA the deduction is mughG Counry Auditor
2J Mo6Be / Manufactured Homes rat assessed as Real Properfy: Must �ile dunng the fwefve [12) monfhs C. .
6efore March 31 of each year the deduction rs swghf. ��
See 2versa side loradditbnal instructions arrd qualrfications. CiIBSON
App6cam ( w buyer- see on �everse ' e)
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T Dis � _ Key rcanha dnwmtirn _ Racord numbc Page
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0.�¢seC value dreal ptopaty as W Mortpage / Cantrarl irdebteCness unpaid as of Mongage I Contract "vWe unpaid as d Is ihe epp�ant the sde
Maztl� i, tl�LL yPar March 7, anent ye2r date ol appliUtion kgal or epuilade ow�R
❑ Yes ❑ No
1tl ro. whal Is his / her exarl share ot interest? H rnmetl wiin somearie oNer than spouse. iMicate wtth v.Trom
tt narne m rem�d is 6ftefenl Nan Ihat W app6ran4 md'uate Celow: Is properry in Question: Mnua%ASSesseO
Real Property � Nmually AssesSed
Moble Fbrt�e IC b1.1-7)
Name «mntractseller � � �
p��y o{ �prn�agee or mntrad sWer (numbr� erM stree; ' te. eM LP e) '
Name af assignee w otMl awner or hol0er M morigage
Mdress ot as9gnee (number arM stree4 �Y, stlte, and ZIP cUtla) '
Dces aPW�nt rnm pfoperty in any oNer If yes. what munt�/1 Wha� Tarirg District? Mas Nis deEUaion Eeen requested on Pmperty
munry in Indmna? ❑ Yes ❑ No for wrtent yeaR � Yes
❑ No
DvaucCOn approved in tlre amount of. .
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D,•-a�v�;- ivo... a� i� � zo zo_
a � zo 20 ...
sigrewre I c mba�aicor Ca r(f �'O. , 1� •° •••• �• i oace (mwun. ear. r��
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I/ We certfy under the penalty of perjury that the z � ' -'� +, Ne applirant is a resident of IMiana antl
avner I wntracl buyer ot ihe aforementioned prop....,
SIB (owneh hA reme) , Date (rnonfh. daY. Yeer)
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FW rev ent addmss of appfitant (numbarard sLee( ' t arM ZIP oode)
1 � L � �� 7 �
Person authorrzed M!y executed Power o(AttcmeY � M IC 61.1-12-0.7 Date (rmnM, day, yea�
AEdress of autlnr'¢ed persa+ (number aretl streeL �: sbte, antl ZlP mde) .
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