HomeMy WebLinkAboutMortgage_Carr (2)"'^ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
FOR DEDUCTION FROM ASSESSED VALUATION
Stafe Form 43709 (R10/11-08)
` � Presaibetl by DepaMien� dLOr� GwemmeM Finanw
WSrnUCilONS: Fle Mark
rooamaam�,sa,aay�a�ma�c«��a�aaa�rr�a�«,�tyWna,�ma��,ry�r��aa. MAY 2 2 2009
Filing Dales: 1J Real Property: Must file dunng the yeer for which the deduction is sought.
2) Mobile / Manufacfured Homes not assessed as Real Property: Must file durirg tlre hveNe (12) monfhs before Maich 310l each yeer
the deduclion is soughL
s� ��� s;oa �. eada;o,w �wc� aoc o�i�r;� �7a f; Q��
Lo/%m,e��
a��a �a� d���y as d
hfa�ch t, amara yea
what ¢ nis ! ner asatl shaa d iMeresYt
on
aur� year
c���e C a�/'
;sucn�a. !s/-�
If owned wilh
Pddress of rtnrtgagee n ardacl seAer (rum6erend sfrt:eG �: sfale, and 21P coDO)
Narne d assigree or other ownar a hoidar d moftpape
�m,
�
� a I i: �rre aaa�n u� sae
legal a eQUitable ame(1
❑ Yes ❑ No
dher Ihan spouse,
� ma v�m � a��+;a,: au,�uy nssessea
] Real PropeM ❑ Mnualy Assessed
Mohile Florne (IC G
ooes apqrant o«n propeny in am� wer n yes, wtai wumr� mut �a:vg oisma7 nas tnis aeauaiu, eeen reaues+ea on v�weM
inindiare9 - � forairram aan
�r' � Yes � N� r
❑ Yes ❑ N
I/N
oan�
- � � ( 1�� . • • • COUN7Y AUDITOR
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���",Ci �Q"� (� j`'�
\O J 20 20 20 20
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C�1[cl � D u�0 ca„ny o-�e mann.aar.r�
���,2-� bs � a a-d
.,� perpiry ihat the above and faegoing mfarmation is true and carreU and lhat the appliwnt is a resident af Indana aM
_..yer of the aforementioned qoperty on date application is filed.
Data (ma�th.
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AddrassdaulhaizedPersan (num6rranESLeN.cq:sbto.andLPcodo)