HomeMy WebLinkAboutMortgage_Maurer (11)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R71 ! 6-09)
�' Presvi6ed by Oepartment of Loral Govemment Finance
File Mark
INSTRUCTIONS: �U
To be filed in person or 6y mail wrfh Ne CounryAUditor or County Remrder o! the wunry where !he pmperty is located. � �
Fiidg Dates: 7J Real Pmperty: Must file dunng the yearlor which fha deduclion is soughG C.' . n\ �_�\.��N Auditor
2) Mobife /Manufactured Homes not assessed as Real Pioperty: Must h7e dunng the twelve (12J months \
befora March 31 of each year the deduction is sought JC�I y Recorder
See reverse side !or addttmnel inshucGons arM qualifications. G I BS 0 N
AppGCant (oxner or� 6vyer - see msUicGUns m reverse side) �.l h . .\. —
1 rahie d rrdi RoP�Y a5 01
ament year
fq. W�N� 6�YS i�12! 0%dC15�ldlB O� Illi2l251�
11 �wr�e on rcwoN a dMerrnf than that o( aPP��4
number
�1- - ' Ud U d �
�. / Cantraa hidebteOrress unpaid az W Mor�qaga I Contrari udebtedn�s unpaid as of Is ttre eppfimrt Me sole
arte't 5 b�� tlate of appOCation legal o{ equ' �de O
P
� if avmetl wiN someo're oNer Man spouse. iMicffie wtth Mmm
AEdress 6/ rtwrtgagce a mntract seAer (num6rl and street crty. state, aM ZIP oode)
Name of "`,��. ee m oNer owner w hdder o( nangage
AGtlress of assignce (number arM atree4 �Y. slate. aM ZIP ootle)
ry in any oNer �,(� If yes,
❑ Yes CjiNo
amount of: �
20 _ � 20 � 20
peM1y in Ouestim: MmuAy Actesse0
RvpertY ❑Annua�yAssessed
(�(�P ��� ,�S° � � L
/
/ \ � A q
Ta 1'a � P V� 1
COUNTYAUDROR
20 _ 20 _
Caunry
._ �
20 _ � 20
� (�+�4
I/ We certify under Ne penalry ot perjury that the above arW foregoing infortnaUOn is We and cortect arM that the appiirant is a resident of Indiana aM
owner I mntrad buyer of Ihe aforementioned property on date appiication is filed. .
��a�e (owneh hID fwne� �/l Date (�. daY. Yea�
�F 11 �esident eCdressBl ap�irant (numDer and SLee( cvty, state. alM
g�153 5. �5(� VJ. �or'
Puson author¢eE by AWy esewted Pawer af HttomeY a b1' IC 61.1�
person (number arM sLeel. tlry, sfafe, and ZIP cWe)
ZnJ. `i�l.
oace (rnam,, dar.,rea�