HomeMy WebLinkAboutMortgage_Hughes^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_. FOR DEDUCTION FROM ASSESSED VALUATION �
S�ta Fam 03709 (R71 / G09)
,' ,.r PresviEeE ty �eparvnerd of lnral GovemmeM Fu�ante
ile Mark
uurRUCnoNS:
b 6e filed in person w by mail with the County Auditor or Counry Reco�der of the coun where the F ��
�Y P�PertY is located
Filfig Dates: 1) Real Pmperty: Must file durirg Ne year (or which Ne deductbn is soughG ty
2) Mobde / Manulactured Homes rat assessed es Real Prt�peerfy Must fiie dunng Me tweHe (12J months
be)ore March 37 of eech yaar the deduc�on is sought Ju �^�Y R
See reverse side 7af adtlitional inshucGons end Qualificafions.
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tt nama m�emrE's G'iRerrnc Nan Nat d aGP�t trMi('ate Delmr.
Name of mortpagee ar mntrsti x9er
Mdress ot rtioryagrL ar mntratl
o� atl�v owner w
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b "^^•.+tY.ina�ryoNtt II (yes
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I/ We certify urWer Me penalty of pe�ury u�a. _.
ow�er � mntaa a,yer or u,e armemerrtioned pr
� �m�a �% �W, �
�A aEOiess of
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Pason a�m�orm.d oy didy ert
ACtlRn d aNho'ived pefaan
dam�rey «ey
�am.
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,I l k�l «e�uirade v.vnen
V v ❑ Yes ❑ No
u�drate wah wham
Is Cre property in puesfim: MnuaOy Assessed
❑ Real aoPe'ty ❑ � naessed
/J � �
Has Ih's deductim Eeen ra9uested an propertY
ror w�n rra�' ❑ res ❑ �
� I �
d toregoing infortnation is we and corteU and ihat Ne appli�ant is a resident ot IMiana arW
on date ap�'xation is filed.
Date (rtvnh, deY. )seh
ar�d
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