HomeMy WebLinkAboutMortgage_Mosley.#°^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
. FOR DEDUCTION FROM ASSESSED VALUATION
Stale Fortn 43709 (RB / 2-07)
��' ` Presrnbed by Department of Lacal Govemment Firiance
iNSrnucnoNS:
To be (led in person oi by mad with the CourttyAuditor o/ the county where the pioperty is focated.
Fding Dafes: 7J Real Pmper(y: DuAng the 12 months before June 17 0/ the year fhe deducGon is to be e/fective. � �f L 3 n Z�� i�
2J Mobile Homes assessed under IC 67.7-7: Behveen January 15 and March 2 of the year the deduction is to be e9eclive.
See 2verse side fa additional insWcfions arnd qualificatbru. m r v_
T�' ;� 1 I Key mim6er,{legal descriplion
l L 1..1 �a� 0�(0-14- I$-,C30;.,.
As�d vdue o( 2a1 PmpatY a tch 1. ar�enl yalr Moriga9e �..y�..�q
artenl ve3f��/
his I her exacl share af irMresl?
If reme m �ecwd
Name
belorv:
of mongagee u oonUarl seller (numbe` aM stree4 aty. state.
Name ot asa9nee or oU�er owner or holder
Address of asvgnee (numbu aM sheef, d
Dces applicant ovm property in arry oU�er
caunly in Indana?
❑Yes ❑ No
Deduc�ion approved in the amounl of:
� � (�,IB C Y AUDITOR
Y
. c�U S--Oo-7 R� a� P 3a(�
;7u�npaid as M March 1, Is ihe app6�nt Ihe sde legal n equitable owne(1
V �Yes ❑ No
If wmed Milh someone dher ihan spouu,
Is Ihe property in question:
❑ Real Property ❑ Mobile Hane QC G 7.
erd ZIP mde)
If yes, whal • v O�'��,�� 3s this deduclion been
DC���'CI' N�.�
r aurent yea(.�
�-
Cal'(� 1� . .....................
� (�S 9�y. �
zo 09 I zo I � I �— I 20 I Za
uested on pruperty
❑Yes ❑ No
�
t�r�u' nryAUditor ^ �`^"Y Caunly IDate(month da ea�
�.,v �1 ��" ��� �
I I We certify un penalty oi 'ury ihat Ne above and foregoing inforrt�ation is true and mrted and ihat the applicants �ras I were a resident of
indiana and own the aforementioned property on March 7, 2b
�rature (owng�s fidl nameJ .
Da�e (rnonfh, day, year)
applicaM
aty, state, aM ZIP mde)
0
or by
Address of aullnr¢eC pasan (number arrd sheet, cAy, stafe, aiM LP code)
Y��