HomeMy WebLinkAboutMortgage_Hayes.r�-"—•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS nt Year
ai _: FOR DEDUCTION FROM ASSESSED VALUATION �, ,
� State Form 43709 (R8/ 2-07)
�' Presaibed by Department of Local Govemment Finance
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INSTRUCTIONS:
To be filed in person or by mail wdh the CountyAuditor o/ fhe courrty where the propeRy is bcated. -
Fding Dates: 1) Real Property: During the 12 months be(ore June 17 0/ fhe year the deduction is to be elfective. �'fa� ,Q�,
2J Mobile Homes assessed under IC G7.1-7: Between January 15 and Marcb 2 0/ the year the dedut6on is to b�eflectiv�'
See reverse side /w addilional insGuctions aml qualifications. GIBSCN COL'A!TY AUDITOR
:Xn (owner wcontrdcY 6uye - ee reshfc(ims on reverse sde) '
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DisUid _ Key number I legal cription Record number Page number
_ _ 3(�:; o -D D.�o38-009
sed ralue of 2al pop�ity as of Mardi 1, aurent year Abrtgage I ConVad indebledness unpaitl as M March 1, Is 1he app6canl Ihe sole legal or equitable owna(
anrent year �� D O O ❑ Yes ❑ No
what is h¢ / her exacl share of irtterest? If ownetl wiih someone dher lhan spouu, indicate wiU whom.
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Name of mortgagee or conVacl
Address of mortgagee w wnUaq uller (number aM shee(. dly. sfa(e, arrd ZlP crode)
Name ot assignee a olher owner or hdder of mwtgage
a1a srreec an, xe�e.
own property in any aner
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❑ Yes ❑ No
Deduction apprwed in the amount of:
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Signawre of Counry Auditor
20 I 20 I 2b
Is �he praperty in ques�on:
❑ Real ProceM ❑ Mobile Home (IC 61.1
�0�3���..�r.ry
j�l":1\�`CC � i
. atad on poperty
�'11'C� �0• '/.':i. �� �W �U �Yes ❑ No
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/�YUiI/� /
20
20
20
I I/ We certity under the penalty of perjury that the above and toregoing intwmation is We and correct and that the appliwnts was ! were a residenl of
� Indiana and ovmer of the aforemen6oned property on March 7, 20
X SignaW^e (�e/s �1 neme) Date (monN, tlay, yea�
J-.. 1' �
address of applicai5t (numberend sfrael. cdy. stafe. aM ZIP ca
ni. LQi,,�p6��� �dm-�1is�nflT
�rized by duy executed Pawer of Attomey a by IC 61.7-72-.07
Address of aNhor¢ed person (numberaM s7eel, city. state. aM ZIP oo0e)
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