HomeMy WebLinkAboutMortgage_Ingler (4)"'� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fortn C3709 (R71 / 6-09)
� � P2saibed hy Departmein of l.oral Gm2mment F�nce
Coun Township Year
I
� INSTRUCTIONS:
To 6e filed in person w by mail with the CountyAudROr or Counry Recorde� o/ the county where the properry is located.
Filirg Dates: f� Real Property: Must fila dunm� the year /or which the deduction is sough[.
2) Mobi/e / Manufactured Homes rat assessed as Real Properly Must file dunng the hveFre (12) months
6etore March 37 of each year the deduction is sought. �
See reverse side for additbnal instrucUOns and
see resvirtnns
aesmpmo
� �� �_ �
amn�yP2r
If no, whal fs his I her ezaU share ot inferestt
It name on 2m�tl is Eilterent Nan Nat o/ appGcan; i�Mifate bebvr.
Name oi rtqrtgagee or mnttact seller
ACd2ss o( nartgagee b contracl sWer (mmiber and sbee4 �+N..state,
Name ot assignee w other owner or halder of mortgage
o� assig�ree (number aM s/ree; ray, slate, antl ZIP cotle)
q;mm o«„ yov , T
IMOna9
oea� avwwee m
zo
unpaid az W
Dra�ver i\'0....���......
cat��� ���o. . a�ll
� ��������............
sPOUSe.
2�12
inry Auditor
Remrd number � Page rwmCer
unpaid as of Is Me appfmant tM sole
kgal or eQuitade ovmel7
❑ Yes ❑ No
Is �he property in puestion: M�uiaDy A1sesxd
❑ Re� aroaem ❑ nm,�,anr a�sed
nnobae rro� nc �i.i
�M�at Tatirg D�sVKI? I Has N¢ detlwYion Eeen reQUested m propvty
For CurtMll Yea(.�
❑ Yes ❑ No
,iry
�
� i zo
I/ We certify under the penalry of perjury that Ne above and foregoing infortnation is true and correa and that the applinnt is a resideni of Irdiana aM
ownel I contraU buyer of the aforementioned property on date apd��n is filed.
d applirant (nupfber antl strect, cify, stata, and ZIP ootle)
Person autMRed by CWy exew�ed PowerW AottneY m by IC 61.1.12-0.7
person (numner a� sbaef, ary, sfate,
Date ImonN, dar, read