HomeMy WebLinkAboutMortgage_Dunlap"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ ; FOR DEDUCTION FROM ASSESSEO VALUATION �
State Fofm 03709 (R71 / 6-09)
� Presnibed by DepartmeN o( Lod Govemment Fumnce
�il
wsrRUCnoNS: �h
To 6e filed in person or by mail with the CounryAuditor or Counry Recorder oi the county where the pioperty is located. F� G�9 l � � �
Filhg Dates: 1) Real Property: Must fJe during the year /or which the deduction is soughG � Counry Audimr
2) Mo6de / Manu(actumd Homes rrot auessed as Real Property Musf file dumg Me Iwehre (12) months �f�
6etae Maich 37 oi each year the deduction is sought A,+1� ��ecorde�
r �r
Seereversesideloradditionalinstructi�o{�sarMqualrfications. ,,,,,,,e,, e_,�..._.. '�-
r rnal popeny as a
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!Aort�aee i co�aaa �
' Mardi 7. a�rtent year
Name ot rt�Mgagee a crntrad seller h�
�l
Addres W mortgagce a mntratl se�er (numbe ar
Name N assiryiee w other ownet or hdder W mortt
Addrass of auignee (num6erantl stree4 ��1: slate,
Does aPd�nt own pmperty in any aher
munty m Ind'vna? ❑ Yes
❑ No
Ordumon approved in tlre amount ot
sbte, aM LP code)
I D1.1 � � cltr,crt J�
o-
�ape I
wmeafre
R�ro �� S9G a�
oio
unPaiE as of Is Ne ePW��I Ne sola
yY1 kgal a equhable awnen
LiF7 ❑ Yes ❑ No
Is the property in Guestion: MnuaM Assesu0
❑ Real ProPerty � Mnually Assessed
Yes. �Mat count�? V�h-•.r_�..., rv�..;,ao__ _.I Has tlls.deduC»n Eee= m VmpertY
�INLA.� �� ❑
COUNTYAi� '
: .K,�
20 20 20 _ 20 _ 20
o?o�o- ,�,6�
Sig�uwreoiCambatla« __ ,
� I/ We certify undes the penalry of perjury that Ne above and toregoing infortnation is We and corteU and Nat Me applipnt is a resident ot Indiar�a aiM
wmer I wntract byyer�of ihe afwementioned property on date appliration is filetl.
Si9 (owne reme) Date (rtmfh. OaY. Y��
PeROn
ary, stata, and
auUmrtrEU person (num6er arM sbee; cdy. slate, and Z!P cotle)
Date (lmrU�. Eal: yea�