HomeMy WebLinkAboutMortgage_Hopf (2)"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBfEDNESS Coun 7ownship vear
__, : FOR DEDUCTION FROM ASSESSED VALUATION
• State Fofm C3709 (R11 / 609) � �
S j Prewi6e0 Cy �epartmem of Locai Govemmenl Firence
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INSTRUCTIONS: t�
To be �led in person w 6y mail with the Counry A�ditor or Counry Recwde� o! the county where the poperty is located. .J A � 4 _ j �
Filing Dates: 1 J Real Property: Musf file durirrg the year for which the deducfion is soughL Counry Auditor
2) Mo6ile / Manu(ectu2d Homes rat assessed as Real PmpeAy: Must file dunng the fweNe (12) months
befwe March 31 oleach yea� the deduction is sought ��ounry Recorder
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Sea�Bl�se side for adtlitiorl8l.insWCtio� and ouali�cafions. I � J V N�/
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Ma�U ar�en[ yeaz
K ro, what fs h's / her e�a sture of u
11 n2me m remttl's dtlfuen� Nan Na
Name ot rt�ortgagee or mntrar3 setler
�I-acb-- a��C-o- oay ����o
i 4Webtedness unpaid as W Morigaqe / Con7aa mdehtetlr�s unGeiE as of is Ni
� O� Data o( appGntion k9a1
If owned wiN wmern¢ Wh¢r ihan spouse, iMirate with whom
Pddress of rrortgagee a contrad se�er (nwMer ard stree4 td}; ffi�. aM LP code)
Name ol assignee or ather oxner w hdder of tmt{
AAtlress of assignee (number aM stree; rdy, stefe,
Dces a�ptinnt wm property in any aNU'
counry m IrNia�? ❑ Ye5
❑ No
Deductlon appmveE in tM ----
zo _
�
iiwecero
UNTYAUDROR
Yes U No
Is the ProPenY in Guestion: MmiaMAssessed
❑ Real Raperry ❑ ArmuallyAssessed
for
�te0 on P�P�Y
Yes ❑ No
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D� a��er \0.........
Coun Date (monN, y,
a �o. .. ..i .............. Q�L - �"�DID
Ca�' � ' �9'° ve and foregoing infortna4on is We and mrtece arW that the appiipnt is a resident of Indiana aM
_.��ertooneA Prt{pErty on date aPDfication is filed.
.,,dmaL � � n oate pnonm. dar.,een
srare,
person (numGerarM streef, Uy. sbte, and LP coEe)
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