HomeMy WebLinkAboutMortgage_Delong (2)� �
.>f—"•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS oiln � Tow hip Year
r�ft�. l FOR DEDUCTION FROM ASSESSED VALUATION °�
State Form d3709 (R8 / 2-07)
��� Prestribed by Department of Local Govemment Finance D E C � 2�0�
INSTRUCT/ONS: � �iI�MaAc
G� p.� /} �
To be filed in person or by mail wifh the CountyAuditor o/ the county where the property is located. �
FBing Dates: 1) Real Property: During the 12 months before June 77 0/ fhe year the deduc6on is to be eflec6vaq cQN C(�UN7Y AUDITOR
2) Mobile Homes assessed under IC 61.7-7: Behveen January 15 end MarcA 2 0/ the year the deducGon is o be effective_
See reverse side /w additional ins6uctions and qualifications.
see
DisUict Key numbet I legal
��
ed value of 2al popefty az d March 1, amenl y�r
whal is his / her enad share of
�me on
Name
seller
des n Record number
-�-doo - o00 � i� - o a<( a-ooB
Mortgage / ConVad iMebledness unpaid as W March 1, Is Ihe app6nnt Ihe sWe legal
anrent year 8 9. o 0 0
U�--�= -/(.�"�-,. _. .
Address of rtwrlgagce w mnUad seiler (number and sfreet. ti(y state, eM ZIP code)
Name of asegnee a ather wvner w hdder of mortgage
Address of assigriee (number aM sfreel, city, stefe. aM ZIP code)
Ooes epplicanl own property in any other It yes, whel counry) �
counry in Indiana?
❑Yes ❑ No
Deduction appmved in the amount of:
��— p_
SigreW re of County Autlilor
wmeOne olher lhan spouse,
Page number
i� � ?
❑Yes ❑ No
�s the propem in auestio�:
❑ Real Hvperty ❑ Mobile Home QC G7.1-7)
ti
Whal T�ing ...^aed on property
D� 71YC1' `
/�`Q / .Jo
�CO��?—
C� ' ��
wun i r AUDROI ��� t(f �\rO• � _
20 20 20 ���•." OO �a •. • • —
— — � ' —
day, yea�
I/ We certify under lhe penalry of perjury tliat the above and fweqoing information is We and cortect and that the applicanfs was / were a resident of
Indiana and owner of fhe aforementioned property on March 7. 20
i� (o�) /� ^ Date (month. daY•Y��)
�
Fesident address of applicant (number and streef. cily. stafe. aM ZIP wde)
i � r% w %C�JU S
Altnmey w by IC 67.142-.07
of authaaed pe'sm (numberantl streaL dry. stafe.