HomeMy WebLinkAboutMortgage_Lindauer'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ , FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (Rt1 / 6-09)
�' ,,,, Presrribetl by OepartmeM of Lacal Govemmant Firence -
INSTRUCTIONS:
b be (led in person w by mail with the CountyAuditw or Counry Recorder o/ the county whera [he property is located.
F�7ing Dates: 7) Real Property: Must fJe durirg the year (or which tha deduclion is sought.
2J Mobde /ManufeUured Homes not assessed as Real Pmperty MustTile dunrg the M1veHe (12) months
6efwe March 37 of each year Ne deduction is sought.
See reverse side !or addtional insfruclions and quelifications.
Appfuant racont�buyer-seerestri-�an tewrsesiee) GIB
T' � � KeY nmber / legel tlesaiDtian
�(v-18- 3Co-�/o�(-000, a.�t,s-oo
Assessed vahie d� pmperty as of A1o�paga / Contrau intlebteEn¢s unpaid as d Martgage I Con� inOebteCnn�.
�Me�M 1. amni ym Mart31 1, a�rterrt yrar tlate of ePP��
�Jc'� Ooa
I( m. whal is his / 1rer eraiY share ol
tt fwrie m ramfd'a Qdferesit Nan 7�
or mntract seUer
e or rmo-aa seuu
Name of assignea m other awner w halder M morigage
ACCrava W assignee (num6areMStreeL my, s+ste, ar�c
C3iai
20
cdy, smm, aM LP code)
ry in eny oNC I Ir yes. wiwt
❑ Yes ❑ No
amauntaF.
�
I I We cerGfy undu Ne pena}
owner I contracl buyer of ih1�
(owneYSfuOna
�F ofa t
� Pason autt�d Dy OWY esewie0
, /ddress af autha'vcO person (num
perjury that
COUNTYAUDROR
� GbhMyAUditw
❑ Counry RemMer
��n t;vUNTY AUDITOR
RemN m�mhc Page wmba
ao r o �c.� a
�mGaid as d U Ne eP�� the mk
v� u No
sPoum. vbKate xtII� w�rom
Is Ue poperty in QuPStion: MnueAy Ass¢xd
�Real ProPertY ❑ Mnua11Y As�sed
DiStritY i
.
— DI'71V'CC ���.....:�.���......
ca�-a .jo: � a ����j� o :
20 20 20 .
Caunry _ � Date (rmN�. daY• Y��)
he a e anE foregoing infortnation is true and cortect and Nat the appGrant is a resident of Indiara antl
>ro on date application is filed.
Date QnanC4 deY. Yge�
andshee(ritystate, Z7PCa
' af AttaneY a M IC 67.142�7
i sneet �: s�ate. en0 ZlPcode)
Date (monfh. daY. Y��)