HomeMy WebLinkAboutMortgage_Strickland^•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
FOR DEDUCTION FROM ASSESSED VALUATION
'r-_ . .• State Fortn G3709 (R11 / 609) �j
�' f Presaibetl by DepaM1meril of Laxi Gwemment Fuance d'
°" � ile Mark
NSTRUCTIONS: ���r
To be �led in person w 6y mail with the CountyAuditor or County Recorder o/ the counry where the prope�ycw
Rfig Dates: 1 J Real Pmperty: Must file dumrg the year Por which (he deduction is soughf.
2) Mobde /Manufactured Homes rrot assessed as Real PropeRy: Must file dunng the tweAre{72)
before Maich 31 0/ each year the deduction is sought.
See reverse side /oraddilional inshuctions arM qualifrcations. _�,,,,,,,,, „
o � rcer �um�oar✓ �gai a / /'F -/ �✓ Q��
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AseaeC rahie d rral popatY a M�(qa9e / Contraa'udehtetl�s _u�n�Paid�as W 1
Marc3i 1, ama¢ Y� �� �� � S Q LJ L/ (
If ro, what "s tvs / her e�ct share of interest? If owned r
It name m mcad is drtFemnt tlwn Nat of appGCant'oMitate �ebw:
Name ot nnrtgagea or mntract uller A'i n �/1 .- ^' -
Name of assignee or other owner w hdder of morigage
AdCress of assgnee (num6ar aM stree4 ury. sbte, and ZIP mtle)
Does ePDtipm wm wo! � ^-- Wnat munry?
ca,�uy��i� "°'�a SIR�U4Rt�D�Y ��`� —
DeCUCnrn aOWo`� 4 I� ` � V% �
Fortn Netl vriN:
Counry Auditor
County Remrdu
�/� mrd mim0er � Pa9e numbel
�
ifraa uMebtedness unpaid as W Is Ihe applirant ihe sde
tion �egal w epuitade ownell
❑ Yes ❑ No
Xtwi ihan spouse. ind'rate wilh wMm
Is tl�e OroD�Y in Guestim: AnmuM Assessed
❑ Real RoPeNY ❑ ?.nrn!�IY Assessed . . .
VJhat Tari�y �istricl? I Fias Iha Cedudion been requested m p�oprJty
for wrrent yea!? ❑ Y� ❑ No
20 _ 20 ZO _ 20 _
runne d Crnmb Aueltw Counry Date (rrnnfi. daY. Y��
I I We certify under the penalty of perjury Nat the above arW foregoing intortnalion is true and mrtect and Nat the applican[ is a resident of Indiana aM
owney(conVacf buyer of the aforementioned property on date appliralion is filed.
v�
Person authorm.M Gy dWy ezecuted Power of AttameY a bY IC F7.1-12�.7 ��, I Date (rtpnN.
PEdress of author'¢ed persrn (numberaM sbeef. dry, state, anC LP code) .