HomeMy WebLinkAboutMortgage_Cox (7)"'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_,. , FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fwm G3709 (R71 / 6-09)
� y„ f Presaibed by DepartmeM of Local GovertuneM Firence �
i1e rk
INSTRUCTIONS:
b 6e filed in person w by mad with the CounryAuditor or Counry RecoNer o! the county where the pro is located. ����
FiRng Dates: 1) Real Property: Mus! file dwng the year for whirh Ne deUucLOn is soughG 2� Counry Auditor �
2) Mo6Ae /ManWedured Homes not assessed as Real Prt�perly: Must file during the hvefve (72) m��.{Z �
before March 31 of each year the deduction is sought. ❑ Counry Remrder
See ieverse side for additional instnxlions aM qualificatrons.
ADP�� ( u�ont2C6uyu'see�.Wictm�mre�erseside) .._.�...e
I °��-[s� a � -a' - Uo - UcJO.
Aa�sed rehie d real paperty es ot ' Mortgage / Contrazl Irdebtetlness unPaM as W
Me1C� 1. alient 1� Mara� �. artenc yw
� m. what Is his / Mr erad share of InterasY! If wme
tl'ume m remrd is Eifterent Uan tlwt of a7P��L "o�C'xate Gebw:
wme m matgayee «crno-aa
rv� �. �i , , i - o,
nearess or assignee Qwm6e. ero saKt cy: smre, aa:
Does epplkant own 7�v�Y in any oth« r
county m InEiana? r-� __ ri ..
zo � zo � zo
/�/i(V�..
7`d�-QO<o � i
;gaga I CanRxY inCebtedness unpaid az
�o(aOPlrcation /��/ V"`i�-t
l
smneone other than spouse. iMirate wil
Yes L 1 No
re ProD�Y in VueSDOn: MnuBAY Ass¢ssed
Rea� Pfopehv Q NmualhAssessed
Mobile Hane (IC 6
Dra�ser NQ„ �0/ Q
Cardi\'0.....��P.`�.r.�-?....... ,�H6��,���«�,�o�m
� artent yea(! ❑ Yes ❑ I
�(�y,a�. ov
20 I 2o I zo I zo
�renae W Camh AWRUr � Counry I Date (monN, daY. Y��
I/ We certfy under Ne penalty o( pe�ury that Ihe above and (oregoing intwmation is trve and mrtec[ arM that the applitant is a resident of IMiana aM
owner! contracl buyer of the aforemerrtioned pmperty on date application is filed. - -
1�7+�e�loNne/s hdl naTN1 //) Date (rnwW. daY. Y��)
- s„- _� .. . w ; �AlsLo-.,l �f'%(
.!'i �r� ...
Pr�son auNO�¢etl CY du�' uewied PwM of Attomey Ey IC G7. t-72�.7 Date (mmM. tlaY. Y��
Pddresa o( author'ved person (numberaiM saeet �: atate. antl ZIP mtle) ,