HomeMy WebLinkAboutMortgage_Jonesti STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS cou Townshi vear
_ FOR DEDUCTION FROM ASSESSED VALUATION
� state F«m a3709 (a71 � &09)
� y,� f Presmhed by Departmerk of LoW GovemmeM Finance
File Mark
INSTRUCTIONS:
A
b be filed in person or by mail wiN the CountyAUditor or Counry Recorder o/ the county where the property is located.
Fifig Dates: 7) Real Property: Must fi1e durirg the year for which the deduction is sought County AuCimr
2) Mobde /Manufactured Homes rrot assessed as Real Property Must file dunng the tweFve (12) rmnths
6efore March 31 0/ axh year the deduction is sayht �� ���
See 2verse side foraddifional instrmctions and qualfications. G�BS I R
ArnfraM(nwrn.rermafaCbuver-saemdri-l:vr_<p��gyery�g5jypl •
�
her ezaci sl�ara ol intei�Y!
II'wne m remd'a QRerem than ttiat ol a0p�ant,
Name of rtbrtgagee or �ontract
Address ot rtnY�agee w
w Uher owner or holder of rt�ortpage
of assignce (number entl svrot �Y, sC
Oces eppti�nt own yoperty in
munry u� InOera? I"1
.t/ � • T .�D � �
intlebtetlness wpaid as of
ard
�1
�
Dra�ti�er i\'O...pZ�J.Q.... —
s unP� as of Is the aDW�� tlre sda
legal a equitade wmrll
❑ Yes ❑ No
irMrcate with wtrom
Is Me P�GertY in Cuestian: Mnua9Y AssesseE
� Real PmPenY ❑ �^�Y �
Mo6le I-lortie (IC 61.
Has Ihis aedumn, oae�, reauestea n, wW�,cy
r« amein veaR r� .,_ _ n
� .�, �o. ....39�......
ductlon approved in tlre amount oE C (�� •••
a
zo zo - zo _ � I py, SCb. ODi _ za _ zo
�(aLae N Cac%b Aud��r Counry Date (monM. tlaY• N��)
I I e rtify urWer the penalry W pe ury at the above and foregoing infortnation is W e and cortect ar�d that the applipnt is a resident of IMiana ard
/ mntrad buyer of the � ed P�PenY on date appiiption is filed.
�., ro n� ramel oate (r,n+vn. dar. Y9ed
Pelson authwaed by duty executeE
142-0.7
Pdtlrnss af auC�or¢ed person (number aM sbae; ciry, ste(e, aM LP
Date (rnMN. Ee1: 3'ee�