HomeMy WebLinkAboutMortgage_Wade"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ • FOR DEDUCTION FROM ASSESSED VALUATION Yv�ar
�- � ' State Fortn 43709 (R11 / 609) � ■p �
�' ' Presaibed 6y �epartmerrt of Lacal GovemmeM France 9
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File Mark
�NSTRUCTIONS:
To be filed in person w by maii with the CountyAuditw or Counry Recorder of the oounty where I�qp�is��d. F�"� �� ��
Filirg Dates: 7) Real Properry: Must file Uunng fhe yearlor which the deduction is mughL County Auditor
2) Mo6ile / Manuladured Homes nof assessed as Real Property: Must fiie dunng Ne �e(13)m, .__ onths
betore March 31 o/each yearthe deducfion is sought '"7C"'�\ ❑ Counry Recorder
See reversa side for addi�ional instructions and qual�cations. _, ____ v V
Tati ���.Jl�+-' V KeY(wm�eF/IegaldesQiPtian Reton
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Asgessetl rdue cQ real poperty as W Mortpag tract iMeEtedness unpaid as o( Mortgage / ContazY indeb[edness unpaid
MarU 7. qarent yeer Mamh y9ar`�� date af epplifation
lJ
If ra, wha� Is Itis I her e.ad share ol interest?
If name on recorE is dirterent ihan Nat of applicant.
Name of rtpxtgagee or mntraG seller
AAdress of mu�agee a contracl seAer (nurtiber ar
Name of assignee or oNer awner or hoker d rtprt(
AEtlress of asvgnea (num6eraib shee4 ciN. sfele.
IimM rnm ryoperty in any oNp
InOiana?
❑ Yes ❑ No
OIbUCi1011 E
zo_
ciry. state. aM ZIP oode)
If yes, whal munty?
W RD� ToS� �A
I I—.33� '
somew�e otlrer Ihan spouse.
Taprg DiStriC?
�
Is Ne aOP��t �e sde
legal w eQuitahle o�me(.�
❑ Yes ❑ No
Is ihe property in QuPStion: MnuaDy Assessed
❑ Real RopeAy ❑ ArmUailyl�ssessed
Modle Fbrtie (IC 61.
Has Na tletlutlim Eeen requested m property
tw cu�rent year+ � �
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Sigtature c I Counb i�" '� �(� ��
� ao-ii
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I/ We certify urWer Ne penairy ot pe�ury mat tpe aoove arw un�y..�yp informalion is We a� correc[ arM that Me applicant is a resident of IMiana antl
owner I mntracl Wyer of the aforementioned property on date appli(atlon is filed.
" ��
(numDer antl sLee(, dl� state.
rn by
Pddress o( auNa'ved person (numberanC 5ree4 my. s+ate.
Dale (rtmN. tlaY.