HomeMy WebLinkAboutMortgage_McCandless (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
FOR DEDUCTION FROM ASSESSED VALUATION ��{{
� Stata Fwm 43709 (R71 / 609) � � '
S,,,, Presvieea ty Dev�� at lxal Govertunem Fuarce
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To be filed in person or by mail with the CountyAud'Rw or Counry Recader of fhe counry whe+e the pmperty is locate� P (j U I U
Fii'mg Dafes: 7J Real Property: Must file dunng the year for which the deduUion is soughG b County Auditor
2) Mo6de / ManufaUUred Homes rat assessed as Real Property. Must file dunrg fhe MeHe (f 2J months
before March 31 o(each year the deduclion is sought .❑ County Remder
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See 2verse side (or additional instnictlons and qualifications. ,/ //
MG� ( m b/u�ynr'- see iestricavu re ') l� T ti
CRJ � �
��g District KeY �wmber I � tion Rem�d num0er Pz9e �wmba
w
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If ro,
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Y mal P�Y as o(
Y�
Name o( rtnrtgagee a mntraa se4er
Addrea of ncngagee ar rvntrarl se�
Name m�,ee a on,« awnn
�a� o� � �����
�t uMkam bebxc
�—
w1 end stree4 �Y. s
nx�rigage
in any aha
� Yes ❑ No
am ur cooe7
If yes, what
s unGaid as o/ Mortgaga / CantraG mdeMeEness unDaitl a d Is tt�e ePP�^� the sole
tlate of app0�tion � a M��� �
�j ❑ Yes ❑ No
If wmed wiN someone oNer ihan sPa+�. iMimte with wFwm
Is tM property in QursEOn: MnuaDy Asvssetl
❑ Real RoPertY ❑ %�^�!aM � . . _
Dra���er NO..oZpl.p........
Card NO. . G��,,3........
. 4��} /yy� ted m pmperty
" '� K.LJ. � Ye5 ❑ �
_,.y
��nJ1 �TTl7i�I_7%I/' �.�'i.im��i_�q.nt.i:i
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2p _ 20 _ 20 _ 20 _ 20 _ 20 _ 20 _
Sigtunrte d Counb AuEitw Counry Da�e (month, daY. Y��
I I We cert'rfy urWU Ne penalty o( perjury ihat the above anA foregoing intortnation is we and correa arid Nat the appiicant is a resident of Indiana aM
owner I contract buyer of the afaemeirtoned property on date appl'ratlon is filed.
�Srya/1 eh hN n/am,e) � Date (rtm1h, daY• YBa�
��- IN' C �Q�.cf`X-C�G�/�
Full idant adOress d appfi�nt (number antl stree4 �; ��. � LP mtle)
� �9y� Sw �.:,- h;i o - 6��
vr,sm wuaraed M eidy esewtea aowa oranomey or M�c G7.1-12-0.7 oate (montl'. dar. rea�
ACCress of aWiatred persm (numbara�d saee4 �¢Y, sfate. antl LP mtle) .