HomeMy WebLinkAboutMortgage_Dunn (3)r
"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hi r
FOR DEDUCTION FROM ASSESSED VALUATION
. - • Sfate Fortn 43709 (R11 / 6-09)
�' Presmbed by Department af Local GovemmeM Finance
F"I
INSTRUCTIONS:
To 6e fiied in person or by mail wdh Ure CountyAUditor or Counry Recorde� of the county where the property is located. F� �� ��
Fi/ing Dates: i) Real Property: Mus[ fde durirg the year for which the deduction is sought. �• itor
2) Mobi/e / Manufactured Homes rrot assessed as Real PropeRy: Must file duAng Me tweMe (12J months
6efore Ma2h 37 0/ eacA yeer Ne Ceducfion is sought. �^ R �
GI 0 C
See reverse side for additional insfn�ctbns end qualrfications.
t rorconvarthN9�-seelCFi'�+smre sid n /1 .
0
m. what Is ha / tm! erxt share of interest?
��
AbMat, / Contratt h
M�th a�rmst year
If name m remd it Q`I'e2nt lhan that o/ app6rani, 6ditate M�rnr.
Name ot moRga9re a mnbxt se4er
Address W nwrtga9ee w
sfate,
(num6er arM atreef, cdy, sfete, end LP coda)
Dces applimnt ovm property in any oNer I If yes. whet muntyt
counry in Intlana? ❑ Yes ❑ No
DeOucSrn aGW�'� u� Ne amouN
,�
Sigrenue NCambnWitor
' 12r�, U � Vv / /�// '- —r /
Iness unpaitl az af Mort9a9e / ContracY cMeb[etlnass impaitl as d Is Ne eppi'imnt Ne sde
earE wava��� ,} ��y� � «eau� v�er.
I (J �, dy,�J ❑ Yes ❑ No
rc oxrree win, wrnew�e atl� u�an soaise. md'�1e wim wtom
� %1/j'�OT11 �6tllt
/�U�J� i _
/hRc.yN�R Sut
I I We certify under the penalry oi perjun
owner I mntrad buyer oi the aforementi
Pgson
aav-���,
by IC 61.742-07
person (number aM sbaef, dry. s�fe. an0 LP cotle)
IS Ihe O�PenY in QueSUDn: MtNe�y Assessed
❑ Real ROpenY ❑ !4nn!�a�!Y A�e�ed
m�
�a��
oa�e o�,o�m. ear. r�n
� v�aPm
❑ No
,a" ��
b fhat the applirant is a resident of IMiana aM