HomeMy WebLinkAboutMortgage_Blume.►-r—•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
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� FOR DEDUCTION FROM ASSESSED VALUATION
- State Form 43709 (RB / 2-07)
''; '' Presaibetl by Departmenl ot Local Govemment Finance
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INSTRUCTIONS
Coun Township Year
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To be filed in person or by mail with the CountyAuditor o/ the county where the propeRy is located. �
Filing Dates: 7J Real Property: Dunng the tt months be/ore June 77 0/ the year the deduction is� to be eNactive. ,f {�N I 3 2��9
2) Mobile Homes assessed under IC 64.1-7: Befween January 15 and Maich 2 0! the year the deducliar is to be eflec6ve.
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Appiicant(owneror a er-see � 'onson 'de) � Q
CIO@(�N CtlyWTY AUI7�tpp
Ta � i� Key number I legal tlescripfio Recortl r Pa e nu
.19-3a-7o I-av i.:� �i-ba� (�� � �
ralue of real poperty as of March 1, curtenl ye�dr Mortgage / Contrad indebtedness unpaid as of Maich 1, Is Ihe applionl Ihe sole legal w equitade owne/1
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�� ❑Yes ❑ No
, whal is his / he� exaci share of inlarest? / If owned with someone other lhan spouu, iMicale wilh whom.
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If name on record is d'rfterenl �han Ihal of applicanl, intlinla Delow: Is �he property in question:
❑ Real P`operty ❑ Mobile Home (ICG7.1-7)
Name of rtwrtgagee or cmiract sellar
nddress ot mortqayce w cm�trae sener (numee. arie weef. cry smte, ara La cade) .
Name of assignee w other ow�rer oi hdtler of martpage
Address M assignee (number aM sLeet city, sfale, eM ZIP oode)
Does appicant own property in arry ather n yea, wha� caw�1 Whal Ta�dng District� Hes u��s dm�aa, eean requas�ed on popeny
courny in Indiana? fw curteM yea(1
❑Yes ❑ No ❑Yes ❑ No
AUDROR
Deductian approved in lhe an C-�C9Ul&tYCI ��i.� � -
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I/ We certfy und Y_ ��� Gp
Indiana and owner of the aforeme���....__ , � •
Sia�wre(ovfie/sMl�me) ./� i '
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Dafe (mmfh, day yea�
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n is We and correct and that the applicanfs was I were a resident of
Dale (monN, dey, yee�
Person aulhorized by duy e�cewted Poaer M Niwney a by IC ('it.t-72-.07 � � Date (monN. tlay, yea�
ofaWhoraedperem (numbareMsb9etdty.s(efe.