HomeMy WebLinkAboutMortgage_Sanders"•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS h Year
__.. - FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm d3709 (R71 / 609)
�' ,,,. 1 Presoibad by �epartmenl of Laal Caovemment Frence
File Mark
INSTRUCTIONS: A U G
To 6e filed in � m�
person a by mail wifh the CountyAUditw or Counry Recorder o/ fhe county where Ihe property is located.
F�7dg Dates: 1) Real Pmperty: Musf �de dunrg the year (or which the deduction is sought Counry Auditor
2) Mo6Be /Manu/actured Hortres not assrsced as Real PropeRy Must file dunrg Me nvelve (72) monNs�%/ �
before March 31 of each year the deduclion is sought. �ou�ry Recorder
SeereversesideloraddifionalinstrucUonsarMqualifcatrons. GIBSON C
I Appfxant (oyviarbr mnfrad tyrysr - see rn�fnrlions m reyerse vde) .
' /7'�S/ ^.SO/-0o�
Mormaae / Contra�Y'udehtedn�s unoaid as at
m. wha[ ts lis I trer ezxt share
If riame on remd a ditfer�[ Wn that ol applimnl, indinte beWw.
Name af rtvxtgagee ar mntrarl seller . D�� ,
Q"La/L.CQ/
Address M mort9a9� or contrad se0er (nurti6er aM strae; city, sta[e.
Dces apphant avm prop�ly in any oNer
munryinlnOiana? ❑ Y2s
Deductirn appmved In the artaum af:
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59�Me d Camty Autlttur
5tate, B/W LP aotle)
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I No
20 _ I 20 _ I 20
/ i / I
IAace of aPP�� . '
Ii owned with saneorre dher than spw
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k Ih
❑ �
Dra���e
Card T
ot_.IIs the epplkant the sale
legal w epuitade rnme(1
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L�
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20_ � av_
Date (nmM. daY. Y��
I I We certify ufWer ihe penalry of perjury that Ne above anC foregoing infortnaiion is We and cortect arW Nat the applimnt is a resident o/ Indiana and
owner I contrad buyer at the aforemerrtw�ed pro0erty on date applicatlon is filed.
�naNre eh hA n�) _ �_ � IJ Date (monM. daY• Yaa�
Full
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Atlaress N aW�u'¢ed person (number and s5eet ary. state, and