HomeMy WebLinkAboutMortgage_Mehringer"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_. = FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 03709 (R11 / 609)
�� f PRSQibeE by DeOa��M of Loml Gwemment Firence
File Mark
INSTRUCTIONS:
To be nr ed in person or by mail with the CounryAUditor or Counry Recorder ot the counry where the pmperty is located.
Fi7irg Dates: 7) Real Property: Must file durirg Ne year (or which fha deduction is sough[.
2) Mobile / Manufactured Homes not assessed as Real Property: Must file dunng the M1veNe (72) months
betore March 37 of each year Ne deduction is sought.
See reverse side (or addit'anel instrucNons and qualifications. �
qppfuant(9qPuorcontraubuyg{-seeryjLicpon5,�mrew�tesidA _ �.... n � /� i I
f vdue cf mal aaperty as
a+min ym
C
Recortl nu '.
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appfication
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ro. Wh21 IS hi5 / h¢! EYdf15h21B Of VItCIPSi?
nyn¢ m�coid is dfiuent Nan Nat ot aPP���. �irate Eelow.
Name M mort6a9ee a oontraU se4er
Mdress of mortgagee or mntract seA
Name of assigncre w o�her owner or 1
�re,
N auignee (wmbcr aM s+ree4 �y. slate, end LP cade)
IipN vim poperty in arry dher If yes. what
Indiana? r-� _ . r-i ..
amount
�e,
COUNTY AL
'¢p� 20_ 20_ 20
O'
Sigredrte d Coimb Audifor C�
I/ We certify under the penalty of perjury that the above and foregoing intortnati
owner I contract buyer of the aforementioned property on date apPlication is file
N ap�l�t (num6er ar�tree4 G6; �fe. anC ZJP code)
s UW0.{�C�ns �. �rar�C,i
EWy execucetl Parer W AWrt�eY � M IC 61.7-12-0.7
person (numbe� erd sbeeL �'/N, sble. an0 LP mtle)
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OC 61.1-i
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