HomeMy WebLinkAboutMortgage_Martin (2)N
^�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Township vear
__ + FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / S09)
�' y„ � P2saibetl by DeparbrieM of LoW Govemment Firerce
File Mark
wsraucnoNS: MAR
b 6e h7ed in person w by mail wifh the CountyAUditor or Counry Recnrder ol Ne county whefe the property is located.
Fitirrg Dates: i) Real Pmperty: Must file dunlg the }rear /or which Ne deduc0on is soughL Coun
2) Mo6ile / Manulactured Homes iat assessed as Real Property: Must file danng the fweNe (72) months ��' b%wditnr
before March 37 ot each year the deduclion is myht. ounty Recorder
See,eversesideforadUitionalinstructlonsandqualfications. GIBSONCO AUDITO
Ap nt(ow,xrorcontrdrtb r-seeresfic0a�nsmreve aside) .
T' Distr'u2 � Key �uanCU / legal dPSaiption RemN number Page numCer
�-a3-oe-i�i_000.as�-oo o i � o�
Avsessed vahc d real poVMY as ot MoR9a9e / ContraG indebtetlness unpaid as of Mw�qage I ContraG i�Meb�edrress unpaid as M Is Me appikanl the sole
Madi 1. armrt year
rc fw. wna� is nis � ng e�ma snare a
app9cant, c�tlicata EeMw.
Name N mart8a9ee or contraa seller �
\
Address W rtart9a9ce or wntraG se�er
Name af azvgnee or otha ovmer or hol
Ooes applipnt wm poperty in any oNer
counry �n Ind'ana? ❑ Yes �
DeEUCrion e7W� in 4re amount af:
zo _ zo
rer and shee4 la1: sbfe, and LP code)
mortgage
sfate. arM ZIP wCe)
a,.> — �( — I E
If ye5. whet muntyl
No
cour
�zo _ zo .
�. � . � , ,ti.,.
I/ We certify under the penalty of perjury Nat
owner / contraG buyer of �he a(wementioned
¢fa� (o.me/s h� name) � . / /
and
ul� ' eM atltlr¢ss of av� nl snumOerantl sLeeL �y stata, antl LP m
b�% S'. ��eSt S%- /�Qu�S�{
Person autlnrizEE by Culy ezew:etl Pw�er of Aitort�ey w by IC 61.1-12-0'7
AGdress o( autha'nEE person (number aiM sbee; dty, 5tale. and ZIP to�e)
tlate of appGfation legal a epuilade ownef?
� ❑ Yes ❑ No
awned with someone oth� than spouse. udkate with whwn
Is U�e P�Dert1' in questim: MfweM AssesuO
�Real Property ❑ Nmually Assessed
r . � �7 � �
Tadrg D'ahirl? Has ih6 M�iCm Ee�n repuestrL m propelty
for w�re�rt Ye�? ❑ Yes ❑ No
zo _
imiation is we and o
is filed.
Dra�vcr NO.....�'.�..�,.� �.......
c���a �io. ......�.a�......
� -7�,9�a.o�
Date (mmN. daY.