HomeMy WebLinkAboutMortgage_Agnew""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
.,_— .
= FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 63709 (R77 / 6-09)
�' ,.�. r Presaibed Ey �epaNnent ol Loml Govemment Fu�ance
INSTRUCTIONS:
To be filed in person or by mail with fhe CountyAuditor or Counry Recorder o/ Ne county where tAe pmperty is located:
Filirg Dates: 1) Real Pmperty: Must fi/e dunng Me year for which the deduction is wught.
2) Mo6ile / Manufactured Homes not assessed as Real Properry: Mwf file during the Rvelve (12J months
6efo2 Maich 31 of each year the deduction is sought.
See reverse side /of addiUOnal inshuclions and qualifications. .
t wnermcPnntrdrYbuyer'se� . reverse^s]Ce) . /I . ..
P�Y
no, wt�at rs lus / M1tt emtl
%(O� V ✓ —
Abngage / Canbacl indebte0ness u
MaTh 1. WrmntyPar
If rame on �emrd is CiRerent Nan Nat o( aDP���. �irate Eelow
Name of rtmrtgagee m m�trdU uller . �% I
Addtess of nwrtgagee w canvaG seAer
w oNrl owner or halEer at mortgage
aM LP wCe)
f/ — (.
7e / Contra
appliofion
If avmed with mmeorre ather than
Ooes epplimnt own poperty in any oNer I If yes, what cvunt}? I Whal
munty in Intliana?
❑ Yes ❑ No
�� �"����Iw
n ecorder
as d Is fie appiivnt the sote
legal or equilade wmeYl
� ❑ Yes ❑ No
uith wFian
Is ihe properry in QuesUOn: Mnually Assessed
❑ rte� a�naerty � �w+ua�N wssessed
Dra���cr \O...f=.�.�.l........
ca�-a �o. }.�.. a�.11.�s........
�1 � OO/ l,l.�+ • �/
�I Yes ❑ No