HomeMy WebLinkAboutMortgage_Rexing"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ + FOR DEDUCTION FROM ASSESSED VALUATION
• Slate Fam 43709 (R11 / 6-09)
�• P Presaibed by DeO��r�t of Ln�al GovemmeN Finarice
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INSTRUCTIONS: �FF���yyy��(�
b 6e filed in person a by mail wrfh the CountyAUditor or Counry Recorder o! the oounty where fhe property is located. ry � � y��'2 Q�'
Filirg Da[es: 7) Real Pioperty: Must file durirg the year for which the deduction is sought. �� � Counry Auditor
2) Mobde /ManufacNred Homes rat assessed as Real Properry: Must file dunng the hvelve (12) marths
6etore March 37 of each year the deduction is sought. C' ' em�d�
See reverse side /or addrtional insWUions and qualifications.
Mpfitant (u»nr�ry( contau bvye� - see (emicnons m reverse siae) _ � i. � c\
af rea1 W�P�Y as ot
� �' � —
If ro. what is his / her ezact sha2 ot interest?
�
1( fwrie on rem�tl 6 Edlemnt N2n VWt W app�pnt. u�Ok
�o���a�,�� G�
0+�� As� e� \�^. ., �
nca� o, � «mno-�a uue.',-- ��,�e, �
Name of assignee w other axner rn halder ot mwt�age
Adtlress ol assignce (numberaM stree4 �'aY. sfate, en7
- — 'UO
e/CanVaatiirMehtetlnessunpaidazof MM
7. wrtent year dafe
1 �1 '1 .-i fi?� ---.
Rtmrd number Page numCu
�b ��
unCaid as N Is Ne s77�t ihe sale
kgal w eQuilade aw�
---- � � No
nuellY Assessetl
ao� I-3�oa
�M��.�vP ,� � � 7, 500. °°
��„� ���, o Y� �o I � '
Deducbon approved'm ihe amount oE
20 � 20
sfy(an,re d co�rt,ry a,d'rt«
Fi�,
I I We certify ufWer the penalry of perjury Mat the above and tore�
owner I contracl buyer ot the ataementioned pmperty on date aE
� (� fiAr�arrre� �
fl ' nt addres W appGrant (num6er and stree(. ory, state. antl ZfP aoc
/tsF Soy bea� L=�e F{
execvted Power W Mmiey or by IC 61.1-12-0.7
Atltlress of ainhatrtd person (numberaM sbee4 �y. sbre, anC
�JC1.c, ►�, 4 CQ41c��.
' "'.� µ� /� '
"� v `
ies0ea m praprJty
�Yes ❑ No
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�ent of IrWiana aM
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