HomeMy WebLinkAboutMortgage_Whitledge (2)'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
• —...
; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fortn 43709 (R71 / 6-09)
\ r Presaibetl by DePartmeM of Local GovemmeM Fmnce �� �: k �.4 �j �.
� f
� ,�. ,�� � g j} Fde Mark
vsrnucnoNS: ' --' 1i,r
To be filed in rson w 6 mati with fhe Coun Audita or Coun Recorder of the cou F� ���
Pe Y �Y �Y nty,whe2 the piop�rty is located.
Fdmg Dates: i) Real Property: Must fi!e durirg the year for which the deduclion is soi�it� b [ � �/ �unry Auditw
2) Mobile / Manufactured Homes rrof assessed as Real PropeAy Must file dunng the fwelve (12) months
before Maich 31 of each year the dedudion a sought C. j, M„7,�-_ _ ❑ Counry Remrder
See revers�e�� �s�id�eL ��L �additional instructJio�ns a_r_rd qualifications. ���{g�—, V�^
�MP����"tusif°r"'=°��N'e��?�yy^^y�rey�rs�side) (I il 7_./-7 ""Y��/L Al/�17rto
Key rwmDer /
h�essetl vaac U real pfopelty as
Mert3� 1, armnt year
It no. wha[ ¢ tris I hu e�a shara of interest?
If nartre an �eWtd 6 Q�Rrmrt Cun tlfat W aVP�t rtW&ate Eebw.
rt�ortgagee n
; .., �
��� � .
a seuer /
R�+
(�►'0.�' a
�
�i���°° � a.. 55 �
�
..eA in the artaunt o1:
20 � 20
20
,,
I/ We ceRify uMer Ne penalry of perjury'that the above and
owner I contraU buyer of Ne a(orementioned property on da
Per„on auNOnzetl Gy tluly exewteC Power of Attpmey or py
Pddmss of autharzed person (number aM sbeet, dry. state, aM ZIP code)
Recoftl rwmDrl � Page mimDri
eEness unpaitl as of Mortgaqe I ContraG "vMeMedrress unpaid as of Is Ma ePP�^t tlx sde
dale of applimlion legal w equiiade ownel+
� � ❑ Yes ❑ No
IWhatia�ong o51riH?
couNrrnuorzort
20 _ 20 _
Is tl�e qopeM1y in quesUOn: MeWally Asse55ed
❑ Real ProPeM1Y ❑ Mnually 0.5sessed
Mobile Hmie (IC 61.
Has Nis dedutlian Eeen reQU�teE m pmperty
for wrrea Y�n r-� '_ r� .
20 _
oate (moruh. day lear)
r�
infwmation is true and correct arW Ihat ihe applirant is a resident of IMiana aM
ion is filed.