HomeMy WebLinkAboutMortgage_Alston.tN� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
State Fpm 43709 (f28 / 2-07)
�' � Presmbed by DePaNnenl of Local GovemmeM Firence
g , � �F1� L
INSTRUCTJONS:
To be fi(ed in persan or by mad with the CourttyAuditor o( the county where fhe propeRy is bcated.
Fding Dafes: 1 J Real Property.' During the 12 monMs before June il o/ the yeer Ure deduction is to be e9edive.
2) Mobile Homes assessed under IC E1.1-7: 8ehveen January 15 and MarGt 2 of the year the deductim j; (q pe,@Aective.
See 2verse side /oi eddAional insWtGons a� qualifications. MHY u 5 2009
AppiiraM (owne`
reshv.iims m
I ptV_
af Mart�h 1. wrenl year
dinterest?
If name on rearA is d'Aferenl than Ihat
�agaeoraonVad
a mMrad seller (numbar arM streeL dly. sfale, en0
assignee a dl�er o.vner w holder af mortgage
���5� �a5
intleWedness unpaid as M March 1.
Addrass of assignee (rami6ersM %�, CT71 /J/ _ / /L� )/�� � � �
H�/�/i• v�ri.
oces epqicant o«n a�wem �� en O 7 '� CO �%
caurrty in Indare?
❑Yes �
omucw� sac�m �n �ne a�,a,ro
20
I/ We certify bnder the
Indiana and o oi th
�retura (o nams)
20
!�'r6� �
>s uo��6
app6rant Ihe ade legal n equitable wrt�eR
❑Y¢5 ❑ NO
wdh someone d1�er Ihan apouse.
i
zo _ � zo _ � za
Is ihe praparty in Wastim:
❑ a� �r�env a Moa�e ri«ne pc s�,.,-»
Has tids detludion bean requested on property
fa wrtmu yeaR
❑ Yes ❑ No
zo � zo
-- ICourrty� y � _ � Date(manfl�Eayyea��
)\ j�_�iS� l% J '�
the above and foregoing infortnaGOn is true and mrtect and tliat ihe applipnts was / were a residenl of
)ertY on yFa(Ch 1. 20
ot P11a�eY w M
aiM LP
Adtlress of author¢ed persm (num6er and sfreeG rQy, sfste, and LP roee)