HomeMy WebLinkAboutMortgage_White (6)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun 7ownship vear
FOR DEDUCTION FROM ASSESSED VALUATION
Stata Farm d3709 (R10 /i1-08)
� � P`asaibaE bY �aPartmant d Loral GovemmeM F�ar�
INS7RUCTlONS: it
To be fded in person or by mad with tlre County Auditar of the county where fhe poperty is focated.
Fli vg Dafes: 1) Real Proper(y: Musf lde dwing the yenr /w which the deductron is sought. ��nv O p �f1f1p
2) Mobde / Menufec6lred Homes rrot assessed as Real PropeAy: Must fde dunra� tlie (weNe (12) morytfie�De(als F7arbp 9V ol each yvar
the deduction is soughL
See reverse sitle lar addEanal inSLud'pns and 4ualifrcaGans
APC��� (owneror miRract dryar- see aypvelse � �
Liv�(.w� ��alv��-- a to — —
Aues5B0 value dreal propa�ly es d 9/ ConlraU u
Ma`ch 1.aareMYear , ameM year
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B ro. whaf a hu / hm e.aC share d irtlerasl?
II f2fnB M RGVd b d�BIBN Ihdfl N31 W apV�l'odimEB bBIUY.
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AUDITOR
tpage I ContrxY indeMedness unpaiL az N Is lhe appli�N Ihe stle
� of app6ration IegW or equdable wneR
❑ Yes ❑ No
someo�re other Wn s7�+%e. iMiCatB wilh wtnn
Is ihe wooeM in questian: Mn�M Assassed
❑ Real Property Q Mnuallyl�sessed
Nan» d essigrea m other ownar ar hdder d mMgape ' _ '
,�����,�„�,�� 6��um G�.y D _ __ -
Doas aV7�t awn pmpe�ty in arry o� � l7Gl-�'"7 '
camry in IMiare1 � Yes
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I/ We ce�4fy under the
wn,er � mno-aa ouver
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Has this dedudian baen raW ested on G�opeM
for a�rteM Y�n e—i __ r-�
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perjury IA ihe above aM foregdng mfartnation is We antl correct and tha� Ihe applicani is a fesident af Indiana and
:mentio propeM on dace appGCation is filed.
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Ia by IC 6-1.142-0]
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