HomeMy WebLinkAboutMortgage_Dunlap^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7 nsh' ar
__ _= FOR DEDUCTION FROM ASSESSED VALUATION
� Sfa[e Fortn d3709 (R71 / 6-09)
�` ,w � PresaibeA Ey Deparirrertl of Laal GovemmeM Firence
File Mark
wsrRUCnorvs:
F �
To be filed in person w by maii with the CounryAUditor w Counry Recorder o( the counry where the property is located.
F7ing Dates: 1) Real Property: Musf file during the yrear ior which the deducLOn is sought C� di��
2) Mo6Re / Manufactured Homes rat assessed as Real Property: Must fiie duAng the IweNe (12J monfhs ❑
be(ore March 31 of each year fhe deduclion is sought � �
See reverse side !or additional inshucfions aM qual�cafions. �
GIB ITOR
AeMY`an�l�h�elaf(YIlIb'df16WCl/SCBlCSfIfl.UfLSIXIRVBlSBShc1 A
� ralue d real pfapMy as d
P apM
1, Wmi1 yP2r
I( rw. what Is his / her eYatl share ot int[
If `wre m �emd a Ntferpst Nan ihat o
Name of mortgagee a mntracl seller
Mdress of mo�n)a9ee w contracl se0er
Name a1 assignee or atl�u awner rn hd
u
MCress of as4g��ee (number aM svee
Dces epplksnt wm pmperry in any oth�
counry in InOiana?
❑ Yes
Deductirn app�avtW m Cre amouni oE
� i Zo _
�3-�- dv-ao/. G-oa 6lQi a�� �
M�r(q ag / Contraa indrbtedness unpaiC as d Mwtgage I Cantrad indeb[eOness unpaid as d Is Ihe app�nt Ne sok
Marrh 1 Qairtem Y� da2e o( aDP�� �al «eWibde ownrf?
o�/� �d ❑ v� ❑ No
u avn,ea wim someone oaier u,an soo�se. �,aicate wia„Mam
ipnt, uMirate Eelmr.
�
5er an stree4 �y. state. aM LP wde)
rtprtgage
�nre, andZ/PCOde)
It yes. what muntY? 1
I No
�
wwnai. �.1 1
Zo �5���
xlty in Ouestion: Mn�aOY Assessed
ProPertv �nm,ualNassessea
Moble Hane nc 6i.
]im bcen requesfed m property
n ❑ Ye5 ❑ i
zo
,�m�wc�,ry,wc��w � ��l ^�wv".e�r.,�n
, � ��O . (7�
I I We certify under fhe penalty o( perjury thal [he above arW foregoing infomiati .___ _.._ I•.,,. a��u �nat me applirant is a resident of InEiana and
owner / mntract buyer of Ne af�men0oned prope�n date�pplication is filed.
��m�e (�r: n,u �ame) �/ VL, Y_.L _ � Date (nnnCi. daY. Y��
� I FWI`�° ent��° o�'°°� nt mber and slreet, tity, sfete. antl [I
'I- l%�/� L. I�VYG �Y� 4kb �
Person auiha¢eE Gy AWy ezewteC Power d A[Iqrney w by IC F1.1-12�.7
person (num6erarM sbee; cify. state.
oace (maw, ear. lea�