HomeMy WebLinkAboutMortgage_Meadorsk
�
0
'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
s FOR DEDUCTION FROM ASSESSED VALUATION
� • Sfata Form 43709 (R11 I6-09) �
�' ,�,. ! Presaibed by Departrnetq a( Lotal GovemmeM Fufar�ce
I�
INSTRUCTIONS: a7�
To be filed in person or by mail wifh the County Auditor or Counry Recorder of the county where the pioperty is located. p E p��
Fi7ing Dates: 1J Real Property: Must �de durirg the year h� which the deduction is mught � Counry Audimr
2) Mobde / Manu/actured Homes rrot assessed as Real Property Must file dunng fhe M�eNe (72) rtronths
6etore March 31 of each year the deduclion is sayht. � n� ��� ��Y Recorder
v�
See reverse sKle lor adtlitional instructbns end quelifications. (J �
MpGCam(mmervwrwau6uyer-seerejtrictiorpawreversesde) . . �
I( m. what ts his I her eraU
-ib'-3�-aoo-ooa. aa.8-o�� �oio Sd-o7
A�ort�a9e/ Contrati inde6tedn�s unpaid as a1 Mortgage I ConJact uWebteMness unpaid as d Is Ihe epp4�ani Me sole
Mamh 1, wrtent tlate oi a0p�tion legal w eWkaNa ow�re!!
O O D ❑ Yes ❑ No
If owneO wiM someofre other Ihan spouse. ind�te with wlrom
It name m n.md'o Cittercnt Ihan that ot aPP��L �Oicate bebw.
Name of rt�ortgagee b tdltrad se9er
ffi�,
oxner or ndaer m mortgage
AECreu of assi�ee (number anC street m1: smte. and LP code)
Ooes epplirant awn property in any othu I If yes. what
munry in IMana?
❑ Yes ❑ No
20
�nabne W Cau
�
I / We ceNfy
�
penalry of
ofthe afor
COUNTY AUDROR
2� 2� 2�
Counry
Is the property in Question: Mnualty AsesuV
�eal RopenY � �^�?�Y �
Dra�ti�er NO..��I v.......
Card ivo. ...�..... 5ao7...
� 7q,°rc.o• �
Date (rn�W�.
�iy that the above aM foregoing infortnalion is W e and cortect artd Nat Me appliran[ is 2 resident of IMiana arM
Nioned property un date aPPiiption is filed.
/. /1 Date (rmr�tl�. daY: Y�
Fup residem atltlr�ss�q apb&�ant (num6erand sbeet �: �fe. antl LP code)
�/9 S. GU1t�iPTou7E,C �Q �i9//�?
Pason aWroReO Oy OWy exew:etl Pwer of Atmmey or by IC 61.t-12-0.7
ACdress of auCmr¢ed person (number and sbee; dly, sfafa, and ZfP rode)
�Y. !��