HomeMy WebLinkAboutMortgage_Jones (4)^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
,_ s FOR DEDUCTION FROM ASSESSED VALUATION
• • State Form 437091R11 / 6-09)
�' � Presaibed by DepartmeM ot Loral Govemment Firance
Fil
INSTRUCTIONS: �vM
To be �led in person or by mail wiN the County Auditor or Counry Recorder o/ the county vfiere (he property is located. F�U1 � 2 ZQ12
Filirg Dates: 7) Real Property: Must file during the year for which the deducfion is wughL �ounry AuEitor
2) Mo6i7e / Manufactuied Homes not assessed as Real Property Must file dunng tAe twelve (12J months � �—
6efore March 37 of each year the deduction is saght. �����
See reverse side lor adtlitional instmctions arM qualifications.
�
Appfxant(ownerorcantrarl6uyer re�irbonsonreversesi�e)�
�� RoP�Y � �
what Is his I Mr erafl share of
If n3m2 On lemltl 6 EiR¢Rf17 Ihan N2'�
Name of mortBa9ee a cmtraU seDer
matgagee w canVad sr�er
�` / I�I �
uNica[e belov.c
w other awner or MtEer of mort9age
AECress o1 assi9�ree (numbar aM stree4 �Y. �te,
Oces epplinnt own property in any
munry m Intliana? � ..
appmved'c� Ihe artaum oE
zo_ i �—
��
No
to0e)
�as of Mortgage
unPald az of I Is the eG�t Ne sole
legal w equiHble ownM
n Yes ❑ No
If owried wiN someane oUrer ihan spouse, iMicate wtlh whom
Is Ihe property in Ouesfion: Mmia�Y A.sesved
❑ Real Property ❑ Armually Assessed
Mob�e Flortie (IC 61.
is Nis detludion Eeen requeste0 on propeny
w�e��y�n r� .._ r�
Dra���er NO��C.� °�........
c��-a �io. ay90
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I I We cert'rfy under ihe penalry of perjury Nat Ne above ard foregoing infortnalion is true and mrtec[ arM Mat ihe applirant is a resident of indiana aM
owner I contracl buyer of the aiwementiwied property on date appiication is filed.
�nanire (owne ) �) Date (morvh. daY. Y��
11 . � i�. � L /i .If� � _
w by IC E1.142-07
person (numberandsbee4aN.
Date (monl�. Efi: Y��