HomeMy WebLinkAboutMortgage_Becht"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES nt n ip Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
� Sfa[e Form 43709 (R77 / 6O9)
S / PresaibeE �y DeperlmeM of Local Goremment FuiarKe
0 2 CU�i�Ma�x
INSTRUCTIONS:
b be filed in Form Ned with:
person or by mail wiM the CountyAuditor of Counry Recorder oJ Ne county where the property is-lay�ted.
Fifirx� Dates: 1) Real Proparty: Must file durhg fhe year for which Ne deducfion is soughL %�(G`� r�, •� Counry Auditor
2) Mobde / ManufaUUred Homes raf assessed as Real Property: Must fi(e during fhe tweNe (72) mont/i,s' �n
6efore March 37 of each year the deduction is saght G I9SON COUNTY A L' U��JR�O1"n' Recorde`
See reverse side /or addlfional instnrctbns arM qualifications.
AooGrantfoxmmrmmntrarl6wv-seerasbiclionsmm`ersestlel i.
Asxssed raAie d rcal PoP�Y as ol
A1erth 1. arrent Ynr
If no, whet k his / her exad shara
name m iemrtl
bu I kgal Eesaiptim (�
/8-3lc- o ,00a 6��- ob
M�y�g e/ Contraa indebtedn�s unpaid as of Moriga9e /�
Merd� 1. arteirt Y� date of aGW
m m�traG seAer (number end
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naamss a assiv�ee cnumne. ane so-eec �1: ue+e.
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20
mnl wm ryoperry in any aher
��? ❑ Yes ❑ No
apya.ed'v� me arm,m ot
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I/ We certify urd� Ne penalry of
rnmer I m tract buyer of the
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Pawn autlnr'ved M d�M ezewted Pw
are Debw
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u,ms, whec W�myr
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20 I 20
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as d Is Ihe epp8mrt tlx mk
legal or equitade owne(7
❑ Yes ❑ No
someone other fhan sD�. (rM'�te wflh Mwm
M me wovenv m auesrion: nnm,aM nssesseo
�eal Prope!tY Q A!°ivally As.e55ed
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� No
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that Ne above aM (oregoing in(ormation is W e and corter2 arW Mat Ne applinnt is a resident of Indiana ard
ned property on date apPlication is filed.
. . / Date (monN. deY. Y��)
MCress of auttmr'ved persm (number aiM stree4 �Y. ��. anE LP mde)