HomeMy WebLinkAboutMortgage_Blume (2).s�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship Year
�,. . FOR DEDUCTION FROM ASSESSED VALUATION
Stale Form 43709 (RB! 2-07)
��� Presaibed by Department of Local Govemment Finance
File Ma
INSTRUCTIONS:
To be filed in person or by mail with fhe CountyAuditor of fhe couirty whera the properfy is located. � MiiR 2 3 2��9
Filing Dates: 1J Real Property: Dunng the 12 monfhs be/ore June 71 o/the year the deduction is to be etlec6ve.
2) Mobile Homes assessed under IC 6-7.1-7: Belwaen January 15 end Marclr 2 o/the year the deduc6on is fo be eflec6ve.
See reverse side (or addifional insbuttions a� qualificafions. �'j/ �/j �/ _
Applicam (owy9r w mntrad buyer -
�.r�_���i.'L�a�a
If name dt
Name of mortgagee or canVacl seller
descnption
a- v�- �oi. 7�- oa�
Mwigage / Contract iMebledness unpaid as of March
artenl year / / � O�^�
U
If owned with someone
Address of rtroM1gagce or mntrad seller (rwmber aM street, dty, stat�F�d ZIP cade)
Name of ass}i$�'1/y r aVrer owrrer or lder f mwt.9I� eI
C . / �� L� /l1lLl.N 7
Address of asvgn e(num6er arH sheef, city, sfate. arH ZIP coda)
Does applicanl own property in any dher It yes, whel counry� VJhat Tazing Disirictl
county in Indianal
❑ Yes ❑ No
i �y i ��
Is Ihe appGmnl ihe Sde legal w equita e owneY/
❑Yes ❑ No
spouse. indicata wit� wMm.
�s u,e propem.fn a�w•� — - - --
D,-a„��►- �o o.R:-..�f�.y..
'
CardNO . ....................
Has l�is tleduciian been requested on property
fw arrent yraYl
❑ Yes ❑ No
� COUNTYAUDROR
Deduction apprwed in the amount of:
2p �� 2b 20 _ 20 _ 20 20 20 _
Sig�ture of Caunly fwEitnr Cwnly Date (mmN, tlay, yea�
I/ We certify under the penalry of perjury that the above and foregoing infomiation is We and conect and Nal the applicants was ! were a resident of
Indiana and owner of the atorementioned property on March 7, 20
Sigr�Wre (owners INI name Date (month, day, yea�
"/
u 2sdenl address of appliraM (numberand s4eet. city. sla(e. arM ZIP wde)
� � i�o G i�a �s%qdr.�r� ���v
Person aulhonzetl by duty ezeated Power of A[Inmey ar by IC 61.1- 2-.07 Dale (mmth, Qay, yea�
Address af aultmraed person (number aM streeL rily. state. aM ZIP mEe)