HomeMy WebLinkAboutMortgage_Wood^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year �
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
,' � Presaibetl by DepartmeM of Local Govemmerq Fi�nce
i
wsrRUCnoNS:
To 6e filed in erson or b mail wiN the Coun Auditor or Coun Recorder o! the coun where fhe ro FO`� �� `�''
v r n a ry a venr;5i�rea.FEB 2 0
FiHrn� Dates: 1) Real Pmperty: Must file dunng the year for which fha detluction is sought ��unry Auditor
2) Mo6i/e / ManufaGUmd Homes rrot assessed as Real Property: Musf file dunng tha nvelve (72) months
before Ma�ch 37 of each year the deducfion is sought C.�J. unty Recader
See reverse side 7or additional insfiictions arM qualificatbns.
App5ca maontractbuyer-see mrewrsesiee) DITOR
Tap�g ' trict Key number / legal tlesciption Remrd number Page numbnl
a�-1 --'103— DD. s-od� aoio aa-
0.srssed vaNe oF2al as W ge / Contraa irdehtedness unpaid as W Matgage / Contracl uWe6te0�ss unpaid as d Is ihe eppfxant the sde
MeiUi i, qrmtl ym 7, a�rtent year Eate d app6cation legal u d�uitade ownef.�
S❑ Yes ❑ No
1r ro, wha� is na � her exaC share w inte�est'/ rc ow�red with sa„earre atlrer than soouu. NeKate wim whan,
tJartie o( moRga9ee n mitrarl se0g `� �
l/_ /16.
Pddfess of rtart9a9� or contraG se�er (nember and sL
Name oi assignee or other ovmer w twlder of martgage
AE42ss of assip�ee (number entl atrce4 my. sla+e,
/i� M �- �
��
Detluciion appmved'u� tlre amouN of:
20 � 20 _ � 24
I I We certify urWer Ne penalry of perju t Ne
owner I mntract buyer of Ne aforeme�tt¢ned pro
Is ihe praperry in question: MnueOy Assessetl
❑ Rea� aioperhi ❑ ��r �
rdY, stafe, arN
de, Z 3 � �, _ �
,,,�,a� ��� �� T�� � �)0 SE R.E�'1 y c� �' `�'"— —
�
couNnauorroa �D�� _ ��a� �
20
nd foregoing infortnatlon is We and mrtecY and that Me applicant is a resident of Intliana aM
date application is filed.
Date (manth. daY. Yea�
Full� 'de add! �/ �ni..(n/� �Y� t�Ql� a��
aeiwn auunRea oy duy e=ewced rower orananay or cy ic ��.�-�z-0.�
Address of authome0 persan (numDer aM stree; riry, stale, and ZIP code)
Date (month. daY. Yae�