HomeMy WebLinkAboutMortgage_Hoefling\ \
�
"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
�� —
� FOR DEDUCTION FROM ASSESSED VALUATION
�• State Fwm 43709 (Rit / 6-09)
S PreunbeE by DepartmeM of local Govemment Frence
d a
INSTRUCTIONS: I'I
To be filed in person w by mail with the CounryAuditor or Counry Recorder of the counry where the pmperty is locatetl. J u fl�
Fil"mg Dates: 1) Real Property: Must fJe dufiig the year (or whith the deduction is sought � Caunty Audi[or
2) Mobde / Manufactured Homes rrot assessed as Real Property: Must file dunng the lwefve (72) months �.
bePore March 37 0( each year the deduction is souyht. C nty Recorder
See reverse side Iof additional instruuions arM qualificafions. NTY AUDITOR
n�'Y`nnt (°'� � orcwvraC 6uyer- s e resb/ic�tions rn reverse siYe) %� c 1
NwF�or ��no-4 �i.l� d\.,���i �� JG�1)eti IZ
Key Munber
a�-_
������o�
�Ma�d� 1, aamnt year
If ro, what is his I her exai share ot interest?
�
Name
Nan ihat o( appficant,
r.= , N
7ee ar mno-aa seuer (nwnbe�
E (2�v S
or oNer owner w holder of mortgage
AdCress of asvgnce (numDer aM stree4
Does applimnt ovm property in any oNei
mumy In Ind'ana?
❑ Yes
-o - op: oeo. o- � �� 7 3
ge/ Contraa irMe6retlr�s unpaid as of Mortgage / C.mVact i�M edness unpaid az ot is Ihe apPfiont Ne sole
1. a tre�t Cate o( appfi�tian legal w epuRade axnM
QJ OO"a ❑Yes ❑No
If owned with someore dher 17an sP�. uW'xxte wiM whom
te bebvr. Is Ne property in Quesfion: MnueP/ Assessed
�o�rty ❑nmuanya�essed
Moble Hort�e IC 61.7-7
�reu�Q a K
e4 �dY, s+e.e. aM LP cade) � . _ '
Has Uia dedudion Deen requested on Pmperty
for artenl yea(�
❑ Yes ❑ No
� \\ COUNTYAUDROR
DeducUOn approved in Me amount of:
�.
20 _ 20 2q _ 20 20 20 20 _
Sigra[ure o( Counb Audiiw Counry Da4 (month. tlaY YQa�)
I I We certify under the penalry of perjury Ihat ihe above and foregoing information is We and cortect arM Nat Ne applitant is a resident o( IrWiana and
owner / contracl buyer of Ne aforementioned properry an date appliration is filed.
5' rewre owners /u0 me) Date (rtionN. daY• Yee�
�F erR aAOress o appfimni (numDerand sbeet, aty, , antl LP cotle)
'f Z S S %l% Q.4.� S s.
Pason auttwi'seE Gy d�A' ezecuced Power af A11ameY M�c �. i-iz-0.� � ., oa�e �ma,m. ear• r��
Pddress of auCVrzetl person (numbei eM 5Lee4 C% sbfe. anC ZlPCatle)