HomeMy WebLinkAboutMortgage_Hurlock^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Co i �II s Year
FOR DEDUCTION FROM ASSESSED VALUATION �
State Fotm 03709 (R71 / 609)
� Presm'bed by �ePartmeM W Lo�l GovemmeM Firence � .
File Mark
INSTRUCTIONS:
F ih:
b be ned in person or by mail with the CountyAuditor w Counry Recader o� the counry where the poperry is bcat �%
FiNng Dates: 7) Real P�opeRy: Must file dunng the year for which tha deducLOn is sought. ntv� q�d�
2J Afo6de / Manufactured Homes not assessed as Real Property Must file durirrg the fweHe (72J3M@$�t� CO U�Ux
befora March 31 of each year the deduction is mught Counry Remrder
See ieversa side for additional instnxtions end quali�cations.
App5mm (owner m mntraU buyel' ape�rasbirl+ovs m reyvtse sCe) L-. n L l
MaU 1, am�V year
tl ro, what is his! her erad
'--�-...'_' .'
Key �wmMer! Iegal desaip6on RemN numhei Pape nur�ei
ai�-�1���pa-�9-iol-oo��iSa-ooZ ���0 3�
�MatCh e. Nrte�rt year e6tetlness unPaid as of �oRg� � iMehtedness �np2iE as d �I a e�ul�tade owr
rtnrtgagee a mntraG se4er �j /�
�./
ot rtartgagce u contrect se0rs (n�mi6er end sveeG �Y• smte. aM LP code)
Name ol assignee w aNa ownu m hdder of rtartgage
AECress o7 assignee (numbar eid sbeeL �Y. state. arc
r ��
H avmeE �viN saneorie other C�an spouse.
Yes LJ No � �
ro / � GOUN7YAUOROR
w'ntoF.�TT '
20 _ 20 _ 20
Counry
Yes LJ No
perty in QuesUan: MnuaOy AssesseE
RoPeKY ❑%��uaDYA�ed
D'e �� .��i�C/� ���0. � b/ � —__
... �..... t
Cat"(� 1�'�.
�
�,� • Y
I I We cerOfy urWer the penatty of perjury that the above arW foregoing infamalion is true and cortect aM Mat the applirant is a resident of IMiana arM
owner I mnvact buyer of the atorementioned property on date appl'u�ation is filed.
,��ow�re.s nm reme) _ _ . . \ o-ata (mami. eer. r�n
� � cS . C.�c+-i.+
i auNwrzetl Ey dWy execute0
Address ot autt�o�vetl vP+"..on
streeL �:`s'tare� anALPac
. �1��
ltomey w by IC 61.142-0.i
LPCOde)
Z-1"� �—1 CD L4 C.7.
Date (monfh, daY. S��