HomeMy WebLinkAboutMortgage_Alderson"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Couni
_ : FOR DEDUCTION FROM ASSESSED VALUATION
• Sfate Fortn G3709 (Ri i/ 6-09)
S I Pmsaibed by Departmertl of Loml Govemmenl Frence
�«.
INSTRUCTIONS:
To 6e filed in person or 6y mail witA the CounryAudifw or Counry Recorder o/ the county where the property is bcated.
Fiting Dafes: 1) Real PropeRy: Must file durir�g the yrear /or whicA the detluction is sought.
2) Mobile / Manufactured Homes rat assessed as Real Property: Must file dunng fhe twelve (12) months
6eto2 March 37 of each year tAe deduction rs sought.
See 2verse side /ur addilional instruUions arM quali�rafions.
AssesseC rah�e of � p(apMy a of
Ma�N i, aarent yea
If rq, what ¢ his l hu eraG share of inL
If name on 2cdd is 6ffuent Nan that c
Name N mort�a9ee or mnttaU se9er
Address of �agee w contraG seAer
Does epplipnt axn property in any oNer
��uy �� i�e���
❑ Yes
DeDucSOn approeed in ihe arrount of:
20 20 _
r� . .��� �
- 6LV - liLl�.: / . - O( V - C7 / �
Mwtpage / Cantra� irdebtedn�s unpaid as W Mortgage / ConvalY uWe6teA`ress unpaid as d Is Ne app�rant Me sole
March 1, artent year date of appGtation /�� legal ❑ Rade ❑ N
Yes
J If wmeE wiM sameone Nhar Can spouse. iMicate wifh vrtnm
�L inEitate bebr- Is P�PenY in 7ueslion: MnuaM Assessed
Real RoPeKY � ?^^!!�1! � .
ier and shee4 �Y. sta:e, qMN
(J
mortgage
smte, LP cajtle) T
��1 — �V
If yns. what muM�?
No
I � I
.�' A < ��a�� �° ��' —
What Tari�g [ ,��` �� No
��/�J�
20 _ � 20 � 20 _ � 20
S'gnature ol Counb Auditur I Caunry I Date (rtronfh. daY. Yea�
I I We certify u�er the penalry of perjury Ihal Ihe above aM (oregoing infortnalion is We and cortect arW Ihat ihe applinnl is a resident of Indiana aM
owner / contract buyer of Ihe aforementioned property on dale application is filed.
/' m(oN'➢eh� name � trate (month. daY. Y��
F� r�de�rt addmss of appGrant (number a � street. d . sta � /V �� TD/V -{- " - � / � / �/
ZV /
PMSOn dWy exew:ed Pawet of AttwneY or by IC 61.7-12-0.7 Da�e (rtmN, d3y, yea� _ ._
PCdress of auNwvetl person 1numDer arM sbeet �: state, and LP code) .