HomeMy WebLinkAboutMortgage_Allen (4)' "'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
State Fartn 43709 (RB / 2-07)
S�•» l Prasa3ed by DeGertmenl of Lacal Govemmmrt Firence
File Mark
lNSTRUCTIONS:
ronefi�av���any,�a,�u�maco�„ryaua;�o.�rma��,�wna�tnaP��ryrsro�rea. APR 1 4 2009
Fding Dates: 1) Real Property: Dunng Ure 12 months be%re June if of the }rear the deductiar is to be eflec6ve.
2) Mo6ile Homes essessed,mder IC 6-7.1-7: Behveen January 15 end Mamh 2 of the yea� Me deducfion is to be eflective�
See raverse side /or addi6onal ins6uctions erd qual'rfications. �� �Q
Applicam (owner mmo � uJ r-^ee re ms n re rse ara
Ta�d is6ict Ke'y number / legal tlesaipti
a _ ���
,�,�e�������,.a.,��. �
aR�
If whal is his / her eza�i shara W irtleresl7
If� m recortl is d'dferent Uun 1ha1 of applicaN, in6ote belo.r.
Name of mortgagee or wNxt sella
Addrass of moM1ga9ee or mntraa seller (mmbei antl stresL dty. s
Narne af azsgnee v oll� awner w hdtler W mortgege
�
Address of assignee (lx ��� ) /► �...'•^ ^Ne)_.
ooas aaWKam wm a� �`—W " /� //�j���
�,��,�dm�� /��73t �CA J
DeduCion
�
Sigrature
��- /�95
20 _ I 20
Remrd
���,,. I�=�a��,t��a������e�,,
❑ Yes ❑ No
Ih sortreane dher ihan spouse. eMicate with whom.
��]
20 _
Is �he property in questim:
❑ R�I PropeAy ❑ Moale Hane QC bt.
F1as tlus
for wrte
been requestea on propeny
❑Yes ❑No
20
Date (rtmth. daY. Y��)
20
I/ We certify under the penalty oi perjury ihat the above and foregoing information is We and corteU and fhal the applinnis was / were a resident of
Indiana and owner of the aforemen6med PropertY on March 1, 20 _
irewre �ers rwi �eme> _ oare �manu�. dar. r��
sram.
G
Pamn aulhor¢ed by duN azea�ed Pw.er of Pi�nriel' a�' IC Gt.1-12-.07 Oata (monN. day, yean
Atltl�ess of aWid¢etl pr�san (number and sheet, aty, stdfe, and LP code)