HomeMy WebLinkAboutMortgage_Alvey"'�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION
• Stale Form 43709 (Rtt / 6-09)
�' d Presoibetl by Departmenl al Loml Govemmenl Fnance
INSTRUCTIONS: �rmp
To 6e filed in person a by mail vdth the CountyAuditor or Counry Remrder o/ the county where the property is located. �7 -[, �� � �
Filmg Dates: 7) Real Pmperry: Must file during Me year Por which tha deduction is sought L j Counry Auddnr
2) Mo6�le / Manufactured Homes not assessed as Real Properly Must file durirrg the tweNe (12) months
before Ma2h 37 of each year Ne deduction is sought ��' R��
See reverse side for addrtronal instruclions and qualfications.
Appfxant (mmer wcmtrart buyer- �ce restri�oons m reverse side) _ �
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Y�
wlat is his
rnmber / le9al desaiPtion
f .II�.�R-
If name on remd a Wf/erent Nan that N appfraN, rtmdirate Gelwr.
Name oj mongagee or oontract se0er
«ca,o-aa
owner w
s�ra,
sfree; dry, stete, arM Z/P oode)
Does aPdimnt awn pra7��' m �any oNer
munry in Indena? hY/. � ❑ No
Lp Y
DflducOOn apprwed in tl�e amouM ot.
20
Si9naMe ot Counry Auditw
�
If yes, what oounty7
COUI
20 _ 20
RemN numl
� oo i , l�'�- oa� �n
unpaid as W Mongage / ContrxY'utlebtednrss �mpaitl as ot
Eate of apptiption
sameane
YMat Taring D'atrict?
20
spouse,
awneR
n No
DbPeRY in QueStim: Mnuelh/ ASSe55eO
�I PfoPem' ❑ ����Y�
Modle Fiat�e (IC G
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Pi���lg
I/ We certify under Ihe penalty of perjury that Ne above and toregoing iniortnatlon is We and correcl and Uat the appiirant is a resident of Indiana arM
owner / wntraq buyer of ihe aforementioned pmperty on date appiipipn is fiied.
I^mWe (ownefz fi¢{r�pq� Date (�, daY Y�a�
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state,
m by
MEress of aWid'ved person (numbera�M sbee4 �'. sbfa, and LP code)
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Date �,rWh. day Y�