HomeMy WebLinkAboutMortgage_Garrett.�.°•na STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
„�._. ,� FOR DEDUCTION FROM ASSESSED VALUATION
�
- Slate Form 43709 (R8l 2-07)
•'e•�; 1' Resmbed by DeParlmenl of Local Govemmenl Fi`wice ��
(� � File Mark
C
INSTRUCTIONS:
To 6e �led in person or by mad wifh the CountyAuditor ol the tounty where fhe property is bcated.
Filing Dates: 1J Real Property: Dunng fhe 72 months belae June 71 0/ the year the deduc6on is to be et(ective.
2) Mobile Homes assessed undef IC 64.1-7: Behveen January 15 and MarcA 2 0( the year Ihe deduction is to be efleclive.
See reverse side lor addilional insWctions and qualifications.
Applicant (oN'F$ %w^6ad bvYe/ - see
a�-a3o��o0�o.��r -�a
real popefly as of March 1, qnenl year Abrtgage / ConVaQ indehtedness unpaitl as of March 1,
anen� �ear _ � �
is his / trer e�G share of inlerest?
reme m record is different Nan Nat
mortgagee or aNlrad selier (numberand sheet dty, stafe, aiM Z/Pcode)
(/
sigrree a other owner w hdder af mortgage
Atldress of asvgnae (mimber arM slreet. city, stafe, aiM
Does applicant wm property in any other
counry in Inaiana?
❑ Yes ❑ No
Deduction approved in ihe amount of:
rzn
SigraWre of CauntyAuditor
20
yes,
�
counryl
�
Remrd
❑ Yes ❑ No
spouse. �cate wilh whom.
Is ihe prapeM In quesUOn:
�eal ProoeAV ❑ Mobile Home OC 6
_ �'(T cQESf�� I�
�A�. .� ��y� �
/'� �uesled on property
V' � Q
�� �U�� ❑Yes ❑No
A
20 20 20
Cwnry Date (rtanfh, day. yea�
I I We certi(y under the penalty ot perjury that the above and faegoing infortnation is We and corteU and tliat tlie appliwnls was / were a resident of
Indiana and ovmer of fhe aforemenGOned property on March 1, 20
vulure (owne/s /WI namel Date (month. daY Y�/1
restlenl address af applicanl (num6er antl sLeet cAy, stafe, aM LP mde)
Person aulhonzed 6y tlu�y
pusm (numbei aM sVeel. aty. stafe, and ZIP aode)
Dale (monN. Qay.