HomeMy WebLinkAboutMortgage_Kohlmeier^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
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FOR DEDUCTION FROM ASSESSED VALUATION
:• Sfate Form 43709 (R11 / 6-09)
S � Pr¢soihed by Departrtrenl af Loml Govemmenl Frence
�1STRUC710NS:
wiN:
7o be filed in person of by mail with fhe CountyAUditw or Counry Recorder o! the couniy where the property is Ioc�.R 1
Filing Dates: 7) Real Property: Must file during fhe year (or which Ne deducfbn is soughL Counry Auditor
2) Mobde / Manufactu2d Homes rrot assessed as Real Pmperty Musf file during the fweNe (72) m�nfhe�
6e/ore March 37 0/ each year the deduclion is sought Counry Remrder
See reverse side /a addiGOnal instruclions and qualficatbns.
e..,r,-�,„�.».rv�rrvmnerarlbuHer-seeiesf+ic0aismreva¢esidel i �
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Key
her e�C share of inteJesi?
r egal6escriVtion Record m�mber
l-!P -loY -DOO. l 37 -DO 7 aZ
Ma�gage / Contract irdebtedness unpaid as of Mort9a9e / Contrect iride6tedness unpaid as W
March 1, artent year date of apdi�ation
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It owned vri� snmew�e er ihan sPWSe. indi�te wtth wha
m �emd is Eifremnt fhan Nat o( appGCan4 mdicate DebM'
rlame ot mwtvasee « mno-aa seuer � p � i� 1"Q'l�iO "'`'�
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Address W mM9a9ee et rvntraG se�er (number end sbceG �1: state, aM ZIP code)
Name o( assi9nee or whe� owner or halAer W morigage
Atldress of assignce (number aM stree4 �1: s�ate, arw
ppes ypp�imn( pwn property in any other
munry in Indana?
❑ Yes ❑ No
Oeduction approve0 c� ihe amount of:
p I �
I/ We certify under the penal
owner I conVad buyer of the
Person authorizetl Ey dSdy exeweed
�P�a��� 3 9� `/��Y/
yes. whal munM YYh3t Tadrg 0
>pfrcanl Me sole
equitahle ame(�
] Yes ❑ No
�ty in Cueslion: MnuaDy Assessed
Proaertv ❑nm,uaiNwu�
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Counry Date (rtmfh �: Y��
Nat the a e arW foregoing infortnalion is W e and cortecl and Nat Me applirant is a resident of Indiana arW
ned pro on date appiication is filed.
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dry, state, and
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� or by IC 67.7
person (num6erarM 5bee4 �'. sbte, and ZIP oode)
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