HomeMy WebLinkAboutMortgage_Humbaugh^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES o o s Yea
_ FOR DEDUCTION FROM ASSESSED VALUATION
. � State Form 43709 (R71 / 6-09)
,�«. � araainee nv Deparvnern or tncal cwemmern Fuwice ' O10
File Mark
lNSTRUCTIONS:
� wRh:
To be filed in person a by mail wiN the CounryAuditor or Counry RecoNer o� the counry wheie the property is loca
Fi!'mg Dates: i) Real Property: Must file during the }rear for which the derluctan is soughL p��ty Auditor
2) MobBe / ManuFadumd Hortres rwf assessed as Real Property Must file dunng the tweNe (12)�pq �s��� TY
6etae March 31 0/ each year the deduction is saght Gt85U Counry Recorder
See reverse side for add"Rional inshuctbns arid qualificafions.
AppGwnt( contraCbuyer-seeQesLicGU reyjGesde) � 1 1 • �
A�etl radre �mai poperty as of hlortuage / Contraa 4idebte��ss unPaiE az
AlErch 7, cvrnnt year Mard� t a�
tl m, what k his / her e� share of interest7 H a
tt fwrc m remC e EHferent Nan that of appOCani, m0icate Cebw:
Name of mortgagee ar oontrarl seller
AdCrea of mon9agee «contraa se0er (nwr'ber ard sb
Name of assignee a othn owner w holder of rtnrt9a9e � V 1 O
Aaaress oi asvqnee (num0er antl atreeR �y. sla+e.
Dces apptimnt wm prap�ty in any attin
cw�uy m �neiana?
❑ Yes ❑ No
Deduc]ion apprwed in dre amount aY.
20 20 _
SignaMe o( CA�mry AWitOr
y �{1�3
� �b, c�c�
20 _ � 20
ristrict7
20
'videbted�wss �mv� a d � �
res u No
IS C12 PIOpCrtY N Q�CSOM: Mf1UZ� ASSMSGE
❑ Real PmPertY Q /vmuallY As�sed
Mob�e Fbme OC 6
s �his de�utlim Eaen 2que5teE an p(openy
arre�n m�/? � .. �
p— � p—
�Y. Y��
I I We certify uMer the penalry of perjury that the ahove and foregoing infortnation is We and correci and that Me applinnt is a resitlent o( Indiana and
amer! mntract buyer of Ne atoremeMioned property an date appiicaibn is filed.
l"a�'re (94^arY NAname) A I I �(�w+m. �Y. Y�) ,
sbee4 �; stete,
or by IC 61.1-12-0.7
Derson (numberand stree4 ury. stdfa, an0
Date (monN. Oay,