HomeMy WebLinkAboutMortgage_Harker"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C n 7 hi vear
:, --.. :.
FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fortn 63709 (R77 / 6-09)
S f Prewi6e0 Ey Departmenl of Lncal Govemme`ri Flrence
wsrRUCnoNS: DEC 2F��[�
Fwm Ned with:
To 6e filed in person or by mail wiN the Counfy Auditw or Counry Recortler o/ fhe county whe2 the pioperty is located.
Filirrg Dates: 1) Real Pmperty: Must file dunng the }rear for which fhe detluction is soughf. ���ounry Audimr
2) Mobile / Manulactured Homes rrot assessed as Real Pioperty Must fiie dunng the fwelve (12) month n �r-C/�nuptv
before March 39 oteach year the deduction is saught OIBSON C UN TT AUpI70hRecorder
See reverse side for adtlitional insuuUions arid qualifirations.
'i MMirani (owner w conHaC bfk'zr- see leshirbons on rererse side) � A �
iam9 uistrrt Key rvxnoer I Iegal eesmptron ' ' RecoN num6v Page n�mbv
�,�v- - I�-4or-000.[�3�-009 p i83
Atsessetl vehie d rrvvl popMy as ot Mortpage / Conbaa indebtedness unpaid as of MoRgage / Contract'u�debtedness unpaid as of Is Ne epd�t the sde
MaNi 1. amnt year Mamh 1, airtent yrar �1 Eate of appG�tion legal or equitable ameR
(8% UQQ ❑Yes ❑ No
If ro, what a his / her e�tl share of interesi? If owned vriN mmeore oNer Ihan spouse, i�xl'eate with whom
tl nama on remN is Oifterent Ihan tlut of aPP��I �ew�1e bebvr Is Ihe property in QuesSon: Mnua%ASSesseO
� Reel Pivperty7 � lVmually PSSe55ed
hbble Fbrne (IC 61.1-i
Name o1 rtnrt�a9ee or contract ulle� n A _ .
, ; ��"-..'"��-' '.1
oNer owner or hdtler ot rtangage
city, sta�.
Ad7mss ol assignce (number aM stree; ary, slate, antl LP cotle)
Does epdirant ovm yoperty in any oNer If yes. what
county m IndFana? �.. �..
20
amount
20
I/ We certify un�r Ne penalry of
owner I mntract buyer of ihe afon
Sigrewre (o��G6 /W nam�^� .
7��
U�'- (��83
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o�m� " J� l�i / i c� "'
COUNTYAUDROR
20 20 20
Counry
20 20
Dafe (mwrth, daY Yee�
that Ne a6ove and foregoing infortnalion is We and mrte�Y arW that the appfinnt is a resideni of Indiana arM
ned Droperty on date applicatlon is filed.
by IC 61.742-07
arM street. cR�: state.
Date (rtmN. daY. Yae�
y