HomeMy WebLinkAboutMortgage_Neidig"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_,. : FOR DEDUCTION FROM ASSESSED VALUATION
• Stata Fortn 43709 (R71 / fa09)
S�.�. � Preunbed by DeP��rd W Ldal Govemmeirt Finarr<
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wsrRUCnoNS: qT+�d�Mi
To be fiied in person w by mail with the CouniyAuditor or Counry Recorde� o( the county where the properry is located. � y U V�.
Fiiirg Dates: 7) Real Properry: Must file dunrg Ne year fir whicA tha deduction is sought. � County Auditor
2) Mo6de /Manu/actured Homes nof assessed as Real Property Must file dunr�g the twelve (72) montAs ❑
6efore Maich 37 of eacA year the deduction is sought ��ry Recorder
6�
See 2verse side 7or additional instructbns and qualrfications. AVp�i +
Aoo5ranL�dvneiormntraCbuucr- mrceersesiYel c „ ' C�
�va4c d mal proprY,y as N Mo�q
1.MentY� MetC}
�i IIO. W�18� 6 �16 � �IPl B1JU 5�18l8 Oi If1iPJP5I�
tt name on n.md is tliSerent than Nai of appGwn4 ��c
Name of morigagee ar mntraclSeUU �
Address U rtartgagee w contraa seAer (numbrl and str
Name a1 assignea w oNri owner or hdder of mortgage
Mtlress ot assignea (number aid sheef, cdy, stete, and
Oces epplkam wm proputy in any aNer
munry in Indana?
❑ Yes ❑ No
�uction approved in Ne amount aE
'/[a—/✓v —�ivci
;/ Contrar2 iMehtedness unpaid as of
a�rtentyear
smm.
20— � p— � p—
Co�mryAUAitor
indebtetlness
i0a61e ownM
Yes ❑ No
ihe D�CeM in auestion: Mmially AssessM
] Real Property ❑ MmUallyAssessed
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pl':1\1'CI- ��... .
�ur ����a �o. ...3.a.(o.�........
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20 _ _ , _ � 20 _
�ate (rtroruh. daY. Y��
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I/ We certify under Ne penalry of perjury that Ne above and foregoing infortnation is We and correct arM Nat the applirant is a resident of Indiana arM
owner I contracl buyer of Ue a(oreipetrtioned pmperty on date application is filed.
Person
tlty,
person (numbefaMSbee;�y,sfate.enOZfPmde)