HomeMy WebLinkAboutMortgage_Topper.+°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township
? FOR DEDUCTION FROM ASSESSED VALUATION
- � S�ate Form 43709 (R8 / 2-07)
�' y�� � PresaibeC by Department of Lacal Govemment Finance
Fil Mark
wsrRUCnoNS:
To be filed in person or by mad wdh fhe CountyAuditor o/ the county where the pioperty is bcated. ,
Fding Dafes: 7J Real Property: Dunng lhe 72 rtronths be(ore June if o7 the year the deduction is to be e/fec6ve.
2) Mobile Homes assessed under IC 6-7.1-7: Behveen January 15 and March 2 0/ the year the deducGon is fo 6��cf�e$ 2008
See reverse side for addiGonal insWctions and qualificafions.
see
saia�I�
al is his I her ezatl share ot Intetesf!
� � .3/— � —/O oo�
m recwtl is d'Aierent than Ihat of appliranL intlipte 6e1�
fmortgageeorcantrxtseller .
_ (J�(l• (�/W u p.�
/ Contra�i indebtedness unpaid aJs�of March 1. Is Ihe appGpnt Ihe sde lapl d eqinla6le wmell
ar /�p� �((J ❑NO
❑ Yes
--�If awned wilh someone dher lhan spouse, indirate with Mrom.
Address M mortgagee u contraa seller �u aIM sbeeG dty. sYafe, aM
Name af assipriee or dl� o.vner a hdder af mortgac,�e
sUeet, city, stafe, arM
Dce ... __ I it �,we. whal counry7
caui
- Dra�ti�er NOa.I.%Q�'- -
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De Card N
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NRia7 Ta�dng
couNrrauoROR
�_ i Zo
is ma wocem �� q��«,:
❑ R�I Propertv ❑ Mobile Home pC G7.1
20
Dale
requested on properry
❑Yes ❑No
r�
I I We certify under the penalty of perjury fhat the above and foregoing infortnation is true and corted and Ihat ihe applinnts was I were a resident of
Indiana and owner of the afwementioned property on March 1, 20
��m��.or.,�Pr fin�.,.rwl Date(monfh.tlaY.Y��
rit address of ap�lkanl (number and sGee(. dty. sfate, an0 LP code)
5, Z,�, �� Ro,Bok UZ �{a�bs+ad�. S
ithpized by duy execvted Power of Altamey w by IC 61.1-12-.
Address of aulhor¢ed person (num6er aM s4eet c1y. sfate, antl ZIP mde)
day, yea�