HomeMy WebLinkAboutMortgage_Bittner (3)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Ye
_ s FOR DEDUCTION FROM ASSESSED VALUATION
� • Sfate Fwm 437091R11 / 6-09)
�' PresciOeE by �epaMient of LaW Govemmenl Fu�ance
INSTRUCT10N5: �t1�
To be R� ed in person or by maii wifh the CountyAUditw w Counry Recorder o/ tAe county whefa the property is located. F� C l, J � Z � � �
Fifrrg Dates: i) Real Pmperty. Must file durrng the yrear /or which fhe deduc0on is wugh[ � Counry Auditnr
2) Mo6ile /Manufedured Homes not assessed as Real Property.� Must file dunng the hveNe (72) months
before MarcA 31 o(each year Ne deduction is spyhG `� �OU^�'�d�
�
See reverse side 7a additional instructbns erM qualificatbns. V
Ap (owneroroonvact r-s 2�ersaside) �
Di Key hr1 / I dewiption Reco�d mmDer Page
iw�nn', � /��T/�-/1�/. �i-O �D
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m 2mC'a dflerent Wn Nat of app6mni, u�tliote Gelow.
Nartre of rtrongagee w oontrad seller
AGd�ess W rtprt9agee w mntract se�er
Name ot asvgnee or oNer o�ner or hd
ovm property in any oNer
a� ❑ Yes
peduction app�oved In me amount oE
wvandsVee4 �N• 5ate, arN:
mortgage
steta, a / code)
If yes, what muntyl
No
aid as ot Mortgage I CantraU iiWe6tedrress unpatl as of Is Ne eppGranl Ne sale
data o( appliotion Iegal w eWiiade owme/7
❑ Yes ❑ No
tl owned wiM someorie oNer ihan . iM'xate Wih whom
Is e ProG�Y in OuesCOn: MmieAy Asessed
Real Roperty ❑ Mnually Assessed . _ '
,3s- 3 -�i
Whal Taring D'atrict?
��'Ll%TY J
`�r�. �
`R ��� - �G-�
20 20 20 20 20 20 _ 20 _
puuue ot Camb Auditor Counry Date (rmVh. daY. l��
I I We certify u�er the penalry of perjury that the above and foregoing intormation is true and correa and that the applinnt is a resident of Indiana aM
owner I wntracc buyer of Ne aforementioned pmperty on date application is filed.
»va (owiWC,t hA �(ne) � Date (month, daY. Y��
l. ` ! \ l ( ��-!
ary, srare.
�tiaR w
P�n auttw�¢eE Dy tlW
permn (numberaM snee4 ctiy. sb�e. end LP mde)
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