HomeMy WebLinkAboutMortgage_Baker (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi ar
:.-_—.
; FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm 43709IR71 / 6O9)
�,.,. � Presrnbed Cy DepartmeM of Loral GovemrneM Fuianca
i e Mark
INSTRUCTIONS:
F
To be filed in person or by maii with the CountyAUditor or Counry Recorder of the counry where the properry is locafed.
Filirg Dates: i) Real Property: Must h!e dunng the }rear (or which the deduction is soughL � Coun Gitor
2) Mobi/e / Manufactured Homes not assessed as Real Praperly Must file dunng the fweNe (72J months �
betore Ma�ch 37 0! each year the deductFon is sought e� R
See reverse side 7or additionel insWCdons arrd qualifications. COU
AppGnnt�rierarcrnfractbuyer'see(e pnreimrseside) n /
/L/ (�((l � �j7 vv — V
raWe cf 2al paper,y az N Mortgage / Cantraa inde6tedness unpaid az of Mwigage
1, cnrnt yw My�ch 1, artent ynar date of ap
1( ro, what is his I her ezact �are of interestl H awne0 wi� swne
tl narne m �emd a Oilfuent Ihan Nat o( appOtart4 uWirate bebvr.
Name of rrortgagee or mntrap seller /�
Address of mortgagee w mntrar� se0er um6er erd sbe
Name of aai�ee oth� � awne m holder W mMgage
AdCress of assig�e umber ard sdee; rdy, slet
Does epplicant ovm yopeny in any oNer H
munry in IndFana? r-� ._ r-i _.
�� � Ilegal O ble O
Yes No
spouse, uWicate with whom
Is ihe praperty in Vu�Um: MnuaAyAS,esseA
❑ Real PropeAy ❑ MnuaAyAssessed
'
•4'Nn/^ � apo`�...
� ��•••••••••.••
p i n�� ct �
wnt)? W�a� Tarin9 D'a � `O • • " � �\ • ' •
_ C7` ��,a`�q1a' , � ❑ No
J
GOUNTY AUDROR
20 _ 20 _ 20 20 _ 20 20 _ 20 _
��riawre N Camry Autlimr � Counry Date (monM, day, Yea�
I I We certfy under the penalry of perjury that the above and foregoing infortnation is Vue and cortecl and Nat the applicant is a resident of Indiana and
owner I corjlact buyer yith� aforemerttioned property on date application is filed.
r�R(a rY7URrr�7 . Date (manfi. daY. Yea�
� /� ( _
Pgson auUrortreA Gy dWy exE
Pddress ot a W�a'ved person
and
ofAttomeY � bY ICs$1.142-07
'sCee4 UN• sfate, andLPOOde)
(rtpnfh. daY Y��
�
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 93709 (R71 / 6-09)
\ / presoibe0 by DeparbnerH of Local Govemme�ri Fu�anca �
� le a `
INSTRUCTIONS: F� �� �_
To be filed in person w by mail wifh the CountyAUditor or Counry Recorder o/ the counry where the pmperty is located. 1 7 '(�
FiTh�g Dates: 7J Real Property: Must file dunig fhe year for which Ne deduction is sought. `� N� QOQriry Auditor
2) MobBe / Manuladured Homes not assessed as Real Properfy: Must fiie during Me twefve (12J months �`�'
6e(ae March 37 oi each year the deduction is suyht � Cau^p' Recordu
See reverse side /or edditional inshuctions and quali�ications.
IAppfnant(owneror�pwaeeuyar-see mre�erseside) OUNTY AUDITOR
K
T�'e DisfiU Key n�mber / legal d '' Remfd numDer Page nu
YYI�m� aG,-i�-.3/ -."�n�,.nn-4 //"�i -n� / �D/� ��o �
AsessM rahie d real P�P�Y � d
�IAazCh 1. GnPfrt yr2r
If ro, what is his l hu e�1 share o
tt name m mmtl a QtReren� than tl
Addtcss of mort9a9ee ar mntrad
rvarne m assgnee a anu awner
Pddfass of assignee lnumber an�
any oUer
Yes
appm.Rd in Itre amoun[ of.
mt hiCicam Geb�r.
) �-n-� � ��.
✓ and sbeel, rAy, smte. eM 21P rode)
rxi9age
afe, entl ZIP cotle)
Ityes,whatcountyt Wtu
No
asd IbNe
I ❑ ves ❑ No
svw+se. uidcate wilh ri�arn
Is Cre P�PeM in 0uestiac AnnueOy Assessed
� Real RoPeNY ❑ !���Y � . ' '
'__—
Dra�ver \'O..a��O........ —
Card NO. ....a�Q�?�...... � No
2p _ 20 _ 20 _ 20 20 _ 20 _ 20 _
�naMe of Camry Aueimr Caunry Date (monM. CaY. Y��
1/ We certify u�er the penalty of pe�ury that the above and foregning informalion is true and cortect arM tha[ Ne applipnl is a resident o( IrWiana and
owner / mntrad buyer of Ne a(weme�oned property on date applinbon is filed.
�vawre law�efS hA remel � /1 Date (manfh. deY. Y��
ss W appfKant (��/and stl�[�tlty, sbte. 3M ZIP cOt
�✓ �� 0 S ��f i.dGi1J'✓1���/
by Ouly ez .etl P'awv+o(Ma�eY a q' IC 61.1-12-0.7
`sm (number aM street �Y, sbte. antl LP code)
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