HomeMy WebLinkAboutMortgage_Pflug^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship vear
_ = FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R77 / 609)
�' � Pr�aihed by DepartmeM oi Local Govemment Firronce
a
wsrRUCnoNS:
To 6e filed in rson w 6 mad with !he Coun Auditor or Coun RecoNer of the coun where Ihe � � Z Q�(�
ve r b N a woaem rs ���ea.
Filing Dates: 1) Real Property: Musf file during Ne year for which the deduction is sought. Counry Audi[or
2) Mo6ile / Manufactumd Homes iwf assessed as Real Property: Must file dunng the hveNe (12) months
6efo�e March 37 of each year the deduclion is mught. u Reoorder
�
See reve e !or adtlifio insNuctions end � s _/
MP�m (m�r contrart uYey�- see m re
, / I �„ ,� A %� �—
Key nuqroF. � �egai
share ot
name m �emN "s d�Remit Nan Nai of aPP�t �ifate Eebvr
Name ot rrortgagee «mntraU seUu
Pddtess of nwrtgagee or mntrati srAer (numDer aM street �: s1affi.
Name of assignee w othu avmer ar hdder ot mwtgage
AdCrPSS ot assignce (number entl aneel, ray, slete. end LP tode)
Does epplifaM own pmperty in am/ oNv I If yes. xfiat
couniyinlnEana? ❑ Y25 ❑ NO
20 _�
s��w� a
I/yJar
amour�t
If wrt�ed wiM someone Wher Man
COUNTYAUDROR
Rem�tl number Page numbrr
�3 � iQ�
�tedness unpaM as d s e eppOrant Me sole '
legal a eWitade ovmeR
❑ Yes ❑ No
sPO�. indicate wiih wtwm
Isthe m0ues�on:Mrn�aOyASUSSed
eal RoPertY ❑ MnuallyAssessed . . .
P�nY
❑ No
— � _ _ 20 _. � I 20 _ 20 _ 20 _ 20 _ 20
Di•atiycrNO...�09 �,�N o���„b,��.�Y,�n
Q[ � ' intormatlon is We and mrtect arW ihat fhe appiicant is a resident of IrWiana aM
Ca rd iVO. .�Q �/�I ... ion is filed.
� . . . . . . Date (monlh. daY YaeA
Iq�;soo c�r� � Y��
io� � ,,., -
M�N ezearted Power o(AttuneY m by IC 67.1-�[-u.� Date (monN. daY Y��
Adtlress af aufhor¢ed person (num0er arM sbeet, tiry, stata,