HomeMy WebLinkAboutMortgage_Luchini"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownshi vear
_ - POR DEDUCTION FROM ASSESSED VALUATION
• Sfata Fwm 43709 (R11 / 6-09)
�' � P�esafEed by Departmenl of Laal GovermieM Finance
File Mark
INSTRUCTIONS:
To be fiied in person or by mail vrifh tha CounryAuditor or Counry Recolder o/ the county where Ihe property is located.
Filirg Dates: 7) Real Property: Must fde during the }rear for which the detluction is wught.
2J Mo6de / ManuFactured Homes rrot assessed as Resl Properly Must h7e dunrg fhe hveNe (12J monNs
be(ore March 31 0! each year the deduction is sought.
See reverse side for additional insVUCGOns arM quali�ications. GI
'AppG�nt(ownerarmntraebuye�-s�qresLirmn.smrewrseside). � l� ` .
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�,.�,� I��,` 3,
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If ro, whal'a his / her eraC Share O( intere5t?
If name on iecatl o CifleRnt Nan tha� of aPP��t h�diqte Cebv`
Name ot rtrortgagcre or mntrarl seller
Pddress of rtiortgagee or mntraG sWer
Dces epp6mnt am pmperty in any oNer
counry m Indiana? ❑ Yes
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/C/o�u!nry� Auditor
hC�]r1tf� Recorder
U
o/- BOO. �o(Q 8- �� C�Y �Sl
dness unpaid as U Morigage 1 Contraa'ubebtedness unpaiE as of Is Ne appGrant Me sde
date af appfcation legal w eQuitade ownefl
� ❑ Yes ❑ No
If ovmed wiN someorre othar Ihan spouse.'u�difafe wiTh whom
I Me PQ+binOuesGOn:MnuaMA.sesse0
�ProPertY ❑MnuallyAsse55ed
Mohle Hort�e IC G7.1-i
'2 _ _ ... _ ` e _ 1. n i ,,. �A- ` _ • � --'. ..
�4Y, stete, antl ""_ ...._. _ - .
,
Drawer NO.....a�......
❑ No
Card NO. ....�513........
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for artenl yea/?
❑ Yes ❑ No
zo zo zo zu n, zo zo _
Ra W�e M Cotmy Audimr� Caunry Date (/navh. CaY. Y��
I/ We certity er the penatty of rjury Nat the above aM (oregoing intortnation is We and correct arM Nat the appliran[ is a resident of Indana aM
owner I mntract buyer of the aforementloned proDerty on da[e applicalion is filed.
y6k�re (o�merY fu0 ry�rre) Date (month. eaY. Y��
Fu0 rnsitlent address of appNant (wmbar arM sbee4 tlty, sfata, a
gd`t Ba.no�Er ` 17Q l��
Person auNa@etl Oy Outy exewteG Power of Attorney or Cy IC S
Pddress ot aWw�t¢ed person (num6er arM saee4 �ry, sb�e. aM