HomeMy WebLinkAboutMortgage_Friedman.p °�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION
2 Sta1e Form 43709 (R8 / 2-07)
S •� Resrnbed by Departmenl of Local Govemment Finarce
w
Year
Fi Mar�1 �
INS7RUCTIONS: �{
To 6e filed in person or by mad wrfh Fhe County Audtor o/ Ihe county where the pioparty is bcatad. jv
Fding Dates: i) Real Property: During the 72 months belore June 11 0! the year the deduttion is to be etfective.
2) Mobile Homes assessed under IC 6-7.1-7: Behveen January 15 and Marcfr 2 0/ fhe year the deducfion is fo qpb�Qct�ye.
See reverse side /w additional inshuctions arM qualifications. ��� r � 7 Z008
7�rg istna' Ke �er I legal desaiption
d vah�e of mal propaty az d MarU 1. wren ymr MMgage / Contracl inde
a�Renl ar��
.
�hat is hls l her exad shafe of iMele51?
If iame on rcr.ord is diflerent Ihan Ihat of appliran4 i�dicate below:
Name oi mor�qagee or conUacl seller
Atldress of rta�igagee a mntraC seller (num6ei aiM sheet. aty. state, arid Z!P crotle)
Nartre of asv9nea w olher avner or hdder of moNjage
Atldress of asvg�e (numbr,r and streel, crty. slale. and ZIP ao0e)
Daes applicanl own popeM1y in erry dher If yes, whffi counry?
caunry in Indiana7
❑Yes ❑No
COU�
Detluction appmved in Ue amaunt of:
�•�,�Q�L�O��
O L.l
as of March 1, Is Ihe appGmnt Ne sde fegsl n ecryritade o,me(
❑Yes ❑ No
If owned wM someone alher ihan spouse.
Is Ihe property in questim:
❑ Real Prqperty ❑ Mobile Home QC 61.1
1 Dra���er NO�!04.:.P��9.�`"
' .' i .. a .. " I
WhatTaxin9� ' l..`ll' \.QN" (..�'� .�y/...:....... r�'
�fli� . ,mi nl,,��O � No
�fS
13�1�7167.
20 � 20
Dale (mmN, tlay, yea�
20
I I We certify under the penalty of perjury that fhe above and foregoing in(wrnation is We and cortect and tlial tlie applinnts was / were a residen[ of
Indiana and owner of the aforementimed property on March 1, 20
� eI(own s hdl name) Date (mmN. day, Yea�
�/ �1 M d A'C/
�ideni address of appl' (number and s4eet city, state, aiM LP mde)
(' D �6X l� N� !.�-�aT�x. `1� G:3`�
n authwaed by duy axealed Power of Ntomey w by IC 61.1-12-.07 Date (manN, Oay, yea�
Address of aulhor¢etl pelsan (num6er arM streeG �+ty. stafe. and ZIP code)