HomeMy WebLinkAboutMortgage_Goedde (8)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Form G3709 (R71 / 6-09)
� PrtsaiOed by Departrtcrtl o( LoW GwemmerLL Fiwice
�� Ft e ark
STRUCTIONS: �
To 6e filed in person or 6y mail with the CountyAUdBw or Counry RecoNer ot the cnunry where fhe pmperty is located. ,1 A
R7hg Dates: 1) Real Properry: Musf file dunrg the yrear /or whiM fhe deduction is soughf. ��� r n� County Auditur
2) Mobde / Manu/ectured Homes not essessed as Real Property: Must file dunrg the tweHe (12) months
6efore MarcA 37 0/ each year the deduclion is sought. C� - ��r Recordu
See reverse side !or additionel instructions arM qualifications. � SY A "
MP�^� (9�`^ffA` O0^tr'M4P�' see rexUirlora m re�'se sde) . � r:185
e� r�n cf �eal OmpatY az
1, anr�n yrar
If no. what a his / twl exaU shera ot int�l?
If nartre m remrE e NRerent ihan ihat o/ appGmnt, mtlinte Eelmr
aea� w �y� o� �o-aa
Name ol assignee or otlrei owner w halder ot nrrtgage
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ACCress o( ass'gnce (number aM.Vtee; tlry, stafe, antl ZIP mEe)
epplirant own property in eny oNer I I� yes. whal
vinlMena? ,—, ,—.
Deductlm approved in ihe amount ot
20 � 20 � 20
5ignaMe d
o � � / a� �P��B'7
6a
s af Abrigaye / Contrac[ trdebtedxs unpaid as d U Ne �p5rant the sok
�•—�—•:.� lepal v equrtade o�rY�
{��u�`�GoEpoE
K� -�
►a -�8�
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COUNTY AUDfI
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20 20
20
Dale (maVh, daY. Y��
20
I/ We certify uMer Ihe penalry of perjury Nat the above and foregoing infortnafim is We and cortect and Nat the applitant is a resident of Intliana aM
owner / mntraG buyer ot ihe aforementioned property on date apqiration is filed.
o( applirant (num6er and sLee( ciry, slate, arq Z/P cotle)
Pason aW�wm.M Oy E�fy ezewteE Vo�rl olAnm�eY ��' IC 61.1-14-0.7
Vo
ce�sa+ (numoer and street. uly, sfate,
oa�e Gmvn. ear• r�l