HomeMy WebLinkAboutMortgage_Meny (6)"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
: FOR DEDUCTION FROM ASSESSED VALUATION
• State Form C3709 (R71 / 6-09) �
�' � PresrriOeC by DepartmeM of Local GovernmeM Firenre
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INSTRUCTIONS:
' Fwm Nad wtth:
To be filed in person or 6y mail with the CountyAuditor w Counry Recorde� o/ Me counry where fhe property is located. , e �n i � u
Filfig Dates: 7) Real Property Must file durirg Ne year (o� which tha deduclion is sought U L t Jd" �unty AuditOr
2J Mobde / Manufadumd Homes rat assessed as Real Properly Must fiie dunng tAe twelve (12J ma�Ns
be7ore March 37 0! each year tha deduction is snughG � ❑ ���Y Re��
i
See reverse sde 7or additi�nal�instnictions arM quali ations. ^� �' ���' '�'
Ap�mnt(ownermaontra -§pe � mreverje � � . !
- ON COUNTY AUDITOR
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Name M mort9a9ee a contraU seQer
Add2ss of mortgagx a mntraa seuer
eo��9a� �v
aal�' ��� �
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I/We
ciEicate Oelmr.
sbeet �: sfe�e,
20 _ 20
the penalty f perjury that the
yer of th menGOned pro
� �
�ppl'mant (number aM sbee(
nde)
rhatmunt�?
����
NRat Ta�drq D'atrict?
i
20 _
e and foregoing infort
on date application is
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k�a�uw �aoa s ��.c��; �.. �;
Pelson auUn�ed Dy duty exewteO Power of Anorney or by IC 61.1-12-0.7 i
Mtlress of aWror'¢ed person (numDer aM sbee; ciry, stata. antl ZIP code) ,
t,IBS
�� � Recard nu � Page num ��
lehtetlr�s unpald as of Is Ne app6rant Ma sde
legal a equitable own�
❑ Yes ❑ No
sPouse. 4id�ta with wt�n
Is ttie property in CuesGOn: Mnua�y Assessetl
❑ Real ProaeKV � !!^^!�N �
Has Na deCUCOOn Oeen re0uestee m P�WP+�Y
for c�t year ❑ Yes ❑ No
2q_ 20_ 20_
y Dace (prop(h, daY.�� �
I C.T
is true and mrtea arM that the appiicant is a residem of Indiana aM
Date (monfi, day, yea�