HomeMy WebLinkAboutMortgage_Wilzbacher (7)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
- FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09) -
� PresaiLW M��N of LoW GovemrtreM Fuarrx
F" e
INSTRUCTIONS:
b be filed in person or by mati with the CountyAUditor or Counry Recader of the county where the property is located. F� ��
Fifig Dates: 1) Real Property: Mus7 ke dunrg Ute year (or which the deductbn is soughG (' �)
2) Mobde / ManufecNred Nomes not assessed as Real Property: Must file dunng fhe hvelve (72) �nihT ` �unty Audhnr
6efoia March 31 of each year Me deduction is sought. ❑ C�u^b Reco^du
See reverse side (or additiona/ ins7rucGOns and qualifrcations.
nt (owner � mnbart buyer msfi�toru m 2 ')
�-
ITa�dng istri Key num0er / legal desrnpUrn
-z
Ed vaWe Ureal pfcpaty a d Mor(qaBe / Contra�
1. tlxm1R yeer Ma � 7. cv �
It ro, what is his / her exad share o( Nteresi?
�wne m fem�tl
Address of morcgagce
ttan ihai of aPP��. trMrcate Delow:
Name af asignee or Ww1 owner w halder ot mtttgage
state, aMTIPwOe)
Mtlress of asvgnea (number aM sReet �: s+ffie, eM Z/P cotle)
property in any oNer
Vc
U Mongage / ConYa
aau or appfrasm
Is Ne appfi�nt �he sde
�ga� w equiH6le ameY1
❑ Yes ❑ No
If ovmed wiN somerne aher Ihan spouse, 4d'uate weh wlwm
Is tlM OroOeKY in QueStion: MnuaDy AssuSeE
�{teal ProPenY ❑ %+!?�!�Y.�
a00� .
Dra��•cr NO ...................
� LJ Yes LJ No I I , j� 1� !o
�f
COUNTY AUDROR C a I�CI � O. . . . . . ... . .. —
De�uraon approued in ihe amount oE
� 175i��.
20 _ 20 _ 20 20 _ eu 20 _ 20 _
Sig�mre ot Camry nwitw Caunry Date (�. dav Y�A
I I We cerCfy urWer Ne penalty of perjury that the above arW foregoing infortnaUon is W e and cortect arW that the applicant is a resident of Intliana arW
owner I mntract buyer M the atwementioned P�rtY � date apd�� � filed.
�denf add�s af appf�nt (number and tlry, slate, a P
/ 3S7 w C��
, aww�aea ey awr �ew�ea a� a nn«,�er �� ey ic �,.,-,z-0.�
prlson (numDe� a� sbaeL �+Y, sbte.
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