HomeMy WebLinkAboutMortgage_Deckard (3)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T shi
_„ FOR DEDUCTION FROM ASSESSED VALUATION �
� $tate Fortn 43709 (Rt1 / fi09)
S,.,. PresaiDed by DeP��rd of La�al GovemmaM Fnanca
File Mark
wsraucnoNS: �
Fcrtn Aed wrtA:
To 6e fiied in person w by maii with the Counry Auditor or Counry Recorder o/ the counry where the property is located.
FiPog Dates: 1) Real Property: Must file dunng the }rear hx which the deduction is so ht Cou, ditw
�9 nty�
2J MobAe / Manulactuled Homes not assessed as Real Prz�perty: Must file dunng Me tweNe (12) months ,G� ��
beforaplarch 31 01 each year the deduUion is sroughG � �_
� GIB..
See reverse side fir abtliWna! �:�::Wctbons end qvalfications. � � " " '
Assessetl vahie d real Pop�Y es of
Ma�di 7. a+'cY yw
n�a.���in��uay,�em�u
tt rwre m mmd'o Q.Re2nt tlun that a
Name af mortg�ee or crntrarl se�er
Mdress of �rar[gagee or mntract se0es
Ma�d� 1, anre�n yrar
Oeb�v
smm.
Name of �ee a oNer awner w holEer of nwrtga5e
AdCrass ot assi�ee (number an0 svee4 �Y, slete, end Z/P oode)
Doey eppfimnc own poperry in any ottre! If yes. wtu
counry m Ind�ana? ❑ Y2s ❑ No
Deduction aPF+� tri C�e artnwLL
20 _ � 20
az
Is C�e appfrcant the sde
legal a eQUitahle ovme/!
n Yes ❑ No
udirate with vrtnm
k me wovem �n a�sm: <++n,a9y wssessea
❑ Real Roa�'i ❑ ��N �
�� 0.lodle Fbme QC G7.
,,-.. .
ll� a tit��i' 1�,Q.. �i�
� Ca�-� 1�;� �"' •
�l3 �Y5Y3
COUNTY AUDROR� � ��/u / �� " • ,
�v
20 _ � 20 _ � 20
���
20
ty Rp� -- Counry Date (monm. qq{�y� �(7^ I O
l%�i �
' under N nalty of perjury ihe above aM (oregoing infortnation is We and carec[ arW that Ne aDW�mnt is a resident of Intliana aM
contract buye f �he ataemerrton property on date appiiqtion is filed.
�wneh NO namel. . � / /� Da�(monfh. deY. Y�� . '
ard
o(Attomey w by IC 61.7-72-0]
Pddress W autha'ved 7e� (num6e� antl sbeaG �Y• sb(e.
Qate (mmtli. daY,