HomeMy WebLinkAboutMortgage_Greubel (5)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun e
�_, FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fwm G3709 (R71 / 609) MAY 4�2 12
i d Presrnbetl M Departmerd af Lacal GovemmeM Fuiance
�STRUCTIONS: F��
Form hled wuh:
To be filed in person w by maii wiN the CountyAud'AOr or Counry Recorder o� the county wl�ere the property is located.
Fd'mg Dates: 7) Real Property Must �le dunng the year Por which the deduclion is sought. G I SO �OOOUl1yq Apy�qqOR
2J Mo6ile / Manufactured Homes not assessed as Real Property Must file dunng the tweHe (72J months
before Ma�ch 31 o/each year the deduction is sought. ❑ Counry Recarder
See reverse srcle for addifional insfructions and qualifications. �
MP6Fa�� (oNmCm contract 6vye� - see rest�ns m reverse �de)/1
legal desaiDtion
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Abngage / Contract indeMedness unpaiA az
Mamh 1. arrent yeer
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If �me an 2oDttl s dMemnt ihan Ihat o( appGrani.
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Nartre o( rtarigagee «mntraG seller I
PdAress of rro�ga9ee w mnbact u�er (num6er il
Name M":s ee w aher owrrer or haider of rto�j
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Add�ess o( assignce (number aM svicet �Y, s�
Dces eDPli�m ovm property in any oNer
munryinlntliana? ❑ Ye5 ❑ No
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DeduGtion app�oveC c� Ihe annunt of.
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Sigrature of Camb Auditor
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as of Is ihe appfcant Ne sde
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V�PQnY ilt QtlP50IX1: MIW 30'f ASSPS.^A'�
eal a.opertv Q ArvwalN Assessed
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1 I We certify under the penalry of perjury that the above and foregoing infortnation is We and cor�ec[ arM that Ne applipnt is a resident of InEiana ard
owner / wntract buyer of the aforementioned properry on date appiication is filed.
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Fill � 'tlen atldress of appGranl (numDeri
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Pr�son auUrofrsetl Cy duty esecuted Power
Atldress M aNhn'aed persa� (numberax
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