HomeMy WebLinkAboutMortgage_McDonald (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ , FOR DEDUCTION FROM ASSESSED VALUATION
Sta[a Fortn 43709 (R17 / 6-WJ
� P�esai0ed M Departme�d of Lmal Govemment Fu�errz '
w.
INSTRUCTIONS: F �d�h
To be filed in person w by mail with the CounryAUditw or Counry Recarder o/ Ne counry where the property is located. U� J V
Fi/ing Dates: 7) Real Property: Must file durirg the year lar which fhe deduction is soughG ounry Auditor
2) Mobde /Manulactu/ed Homes not assessed as Real Propefly Mus! Ae during Ne hvehre (12) monNs
6e(ore March 37 0/ each year Ne deduclion is saqht. e�ef
6
S@e 2verse znde foraddiGonal instructbns arnl quelificatinns. /� � _ .__...,�.. . i iniTCtR
ii.f111Pl1IyPN , /
If ra. what ts his / hu erai2 share
tt name m reoo�d "a Qiilerent Nan
Name of morl�CB or mntract n
'��'�`�� i� � o� Da0d73-cP
y���q���ee/ Contra�$�$yy�1���{ rbteEneu unpaid az d Mortgaga I Conract
flOfOli.WfRl1I1C�M^—^� dd'I20�8[I�CdbOfl
Q..✓ �J l./�.%
%-�o�maO vriN sorrieone otl�er �
Mdrea of rt�cgagee ar mntrad sr�er (numDtv erd svea4 �: smte. and LP cade)
Name m assignee v aare� on„er «ndda. a rtangage
PdC�e55 0/ a55iry�ee (num6ei erltl arteeL dty. s�. aM LP catle)
Does appiirant o.m poperty in arry otlic If yes. �Mat munt� V1tat Tarin� D'strirl?
counry m InC'ana7 n Yes ❑ No
- DI'�IYC'I" 1����,0! � �
' C81-�j\iO�..�.(.�/
M1YI1M / COntl'd�t bUYCI OfVlb e�um......__.._ _. _
auNu'¢ee Oy Mtly exewtetl
� ot auNOr'vetl persa� (num
� ��
blCdlIESS Yf1p21E ffi Of �9Ih0 eppGCS�iI i1M 50�2
IG�3� Of EQII�IdEIC OMIG(I
❑ Yes ❑ No
spouse. indrate w%h Miiom
IS IhG D�G�Y VI V116bIX1: M�U211Y ASSMSEE
❑ Real Pmpenv ❑ ilrmuaM assessed - . -
:tW m yopelty
Yes ❑ No
20 _ 20 _ 20 _ 20 _
Caunry �ate (rto�vh, daY. �
�D �I
j foregoing infwmation is We and cortect arid that the applinnt is a resident of IfWiana aM
:ate applicatbn is filed.
Date (rtmitl�. daY• Y�A
tity, sjat� artl LP
ard sLee4 �ry, sbfe. and LP code)