HomeMy WebLinkAboutMortgage_Dunn'° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou Tiownsn Y
�_,. _ FOR DEDUCTION FROM ASSESSED VALUATION
- • S6te Form 43709IR71 / 6-09)
� w. PresrnLOtl tY �epartme�n o1 LOtai GovemmeN Fwnte p� "
INSTRUCTIONS: ,F�1'M�`�`2 2009
To be filed in rson or b mail wiM the Coun Auditor or Caun RecoNer o/ fhe wun where the �� �� ��
Pe Y �Y �Y b P�PeAY is located.
Fi/ing Dafes: i) Real Pmperty: Must IJe durirg the year /or whirh fhe deduction is sought. ��
2J Mobile /Manulactured Homes rat assessed as Real Pmperty: Must f+le during the fweA�e (72J months '�i"'� ���ry�Rem���
before March 31 a! each year the deductFon is saeght. � UNTY AU��R
See reverse siCe /or addrtional inshucfbns arM quali�cations. C'�
iAppfiran vmn a -aee�ns re�ersesEe)
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�' Taang 0' Key nrtnber / kgal desaiDtion Ramrt1 rvunba P num
' a� -i -i -�o �-oo�. a 7 / -oa �
I� �� popeM1y at ot Rbrtnape I�tra� ehtetlness unpaid as of �MOrtgag P�� indeb[Mness unpaitl as ol la�� ��ion� �
11 rt3i 1 yv ���� ❑ Yes ❑ No
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17 no, whaf's h's / her erstl share Of intr�l?
If rwrie m rtmtl's CAIrRnt Ihan WI of appManf, lnd"�te beb�r.
Name ot rrotgagee or contract seYer
a wntrad
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JJu u N ��r,�.
. Pa�,
If wnred wiN smieme dMi Ihan spave, ud'vte riC� xM�n
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Does eppli�m o«n property in any oNe
county in Indiana?
❑ Yes
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Is ihe papary m Guctim: MnwAy Aswssed
[�eal Pmperty ❑ ArmualyAssessed
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Date (moaM. day, nar)
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I I We certify under Ue penalry o� ye��wy u�d� ��� d„�,.� a�ti �.,��y����y ����...,�e,...�� �., ,,,.....�,,. ,..,.:ect and Na[ the applinnt is a resident ol Indiana arM
owner / ntrati buyer of the afaeme�ed pmperty on date application is filed.
or by IC G7.1-12-0]
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lddressolaWnrvedpuson (numbPianASlicet.aTy,sfa(e.artlLPmtle) . . I
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