HomeMy WebLinkAboutMortgage_Ferry^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
� Spte Fam C3709 (R71 / G09)
�' � Presaibed by Department of Local Govemment Firiance
ile
�STRUCTIONS:
Fo
To be filed in person or by mail wiN the CounryAuditor or Counry Recorder o/ the wunry where [he pmperry is Iocat�AY 0
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought.
2J Mo6�7e / Manulactured Homes irot assessed as Real Property Must file dunng the twelve (72J months
before March 31 of each year the deducfion is sought C���
See reverse side for addifional instnictions and qualificafions.
Appf�n(ownerortantraCbuyer'seeresRicbonsmreversesife) �J
// _ i /.l . J ��
n V ' I �
0.sesse0 rahie of real P�Y a d
A1arch 7. armnt Ymr
If no, what R his ! her ezact share of interest?
It name m�ecatl a d�ftuent Nan Wt o/ appl
Counry Auditnr
County Recorder
r
r/IegaltlesaiP� Reco . ber P umber
-I y -o� - �oo - ovc�. a a -ov � �5
Mortpage / Coniraa "ude6tedness unpaid az N Mortga9e / ConraG uWebtetln�t �mpaid as d+LS Ne app&ant tlx sde
Mamh 7, wrtent Y� Aate of apP�� legal or eWitade ow�ce(.�
3 a Q � Q ❑ Yes ❑ No
If avned wiN someone other than spouse, iM'rate wIN whorn
�, uMicate betrr. Is Ue ProOPrtY in Vuestion: MnuaOy AssessM
❑ Real PfopertY Q Mnua1�Y As�sed ...
Nartre o( rtartc�a9ee a mnVaG se0er �� � � � � � /
[��'.`„„�`C/'�G/ � C... � �
pdtl2ss W rtqrt9ag¢¢ or contratl se�er (mmber and street riry, sta�. ard LP mde)
Name o( assignee w oMer owner or hdder at morigage ��� � �' �, � �.�
PLE ot asvgnee (number aM snee4 �Y. ��. and ZIP cod
7 sw NF - , � �n
Dces epplirant o.m yoperty in any oNer If yes, w `` 'r JCv
counry in IrMena? ❑ Yes ❑ No �/ l�V
. l� —a515
or
:deduCion
ant yeaR
(/I • �/�' �
� , � , zo , �
m prapeny
❑ No
�_ zo_
oa� crm�un. ear. r��
I/ We certify under the penalry of perjury th�t ihe ahove ar�toregoing infortnation is we and correct and that the applirant is a resident of Indiana aM
owner I conVact buyer of the aforementioned property on date appfira4on is filed.
resitlem
tluty executeC Ppxer o1
Atldress oi auNOr'¢Ed person (numberarM sbcef, dry, sfate, antl Z1P code)
0
S- i0 -/
Date (montA, daY.