HomeMy WebLinkAboutMortgage_Strickland (3)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
, : FOR DEDUCTION FROM ASSESSED VALUATION
• State Foim 43709 (R11 / 6-09)
�' ,,,, T P�saibeE by DeparimeM of Laral GovemmeM France
lNSTRUCTIONS: ��
To 6e filed in person w by mail with the CountyAUdito� or Counry Recorder oJ the counry where the property i t F
Filirg Dates: 1J Real Property: Must fde during the year Por which fhe tleduction is sought. Counry Auditor
2) Mobde / Manufactmed HoWmaes not assessed asSRo'emal Pmperty: Must �/e dunng the nvelve (72) mo S E P 2 L4l-1� ty
betore Maich 37 of each r Ne deduction is ht Coun Remder
See reverse side lw adtlitional instruclions and qualifications. _ _
n �-
Ta ' Oistriri Key rw
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1S7a�U1 dr�encyear
If m. whaf Ls his / hx e�J slwe ol intrlest?
If fwne m 2md is diRerent Ihan Nat of appl
Name ot rtnrtgagee b mntract s I r
U��.
Pddress ot mMgagce w contracl seDer (num
'-/�/ -i -.300 �o. U� / aa
Mw(qage/ Contrau irdebtetlness unpaid az d Mortgage I Com
March 1, curten[ year date of eppikati
name o� �ee w o� owne� o� naae� «mort9aye
Address of asvgr�ee (rrumber aM stree4 �: s+ate, am
Dces aPpli�nt wm pmperty in any other
munry in Intliana?
❑ Yes ❑ No
—G
D�uclion appraved in Ne amount of. �
20 20
sig�n,re or camb nuditw
crty, srate, am ur ooae)
aa �
as d Is Ihe applifant the sde
legal p epuitade awne(?
❑ Yes ❑ No
If ovmed with somewie aher Ihan spouse. iMipte wtth whom
Is tlte P�PertY in Gue^�tion: MmuM Assetsed
�ieal Property Q Mnualy Assessed
Dra�S�c'r�\O..°�.a,��.::.
„ .....�, Card 1�`O. °2aJ'�
r�.,�i�myi wn�� ........:....:....... p,c�a�,i
��,o.s�r. � I'�7Y91 Q0 ; ❑ �
—/J COUNTYAUDROR �. �
20 20 20
Counry
�
Date (monN. day, lea�
20
I/ We certify u�er the penalry of perjury Mat Ne above and (oregoing infomwlion is W e and cortect a� Nat the applirant is a resident of IrMiana aM
owner I mntract buyer of lhe aforementioned property on date appiicatlon is filed.
address ot appGwnt (wmber enE s�ree4 ary, state. arM ZIP aotle)
by Euy ezecuted
P4Cre55 of auNOraed person (num0erantl5bee4 �y. state, and Z1P code)
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