HomeMy WebLinkAboutMortgage_Armstrong"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C Year
__ _ FOR DEDUCTION FROM ASSESSED VALUATION
' s�ar-«maa�o9cRnibw� JAN 7 ZO10
� � rresaieea �r oepanmern or L� covemmem Flr�anrx �
� File Mark
IN57RUCTIONS: '�j�
b be filed in person or 6y mad with the CountyAUditor or Counry Recorder of the counry where the property is bcat�d � ��
Fitirg Dates: 7) Real Property: Must file dunrg the yrear /or which the deductlon is soughL � IpC�tJ CO NT1�U4�Qi�y Auditw
2J Mobile / Manulactu2d Homes not assessed as Real Property Mus! file dunng the M1veNe (7Z} Fiibn7hs � �nry Recorder
6etore March 31 0/ each yexr Ne deduction is sought.
See reverse siCe for addiWnal instnictions aM qualificafbns.
MP�M (cw�orcontrarl buyer' aea resfir�jrq m ie�erse aidD)
I rdue d real poperty az o(
anent yrar
tt ro, whal is his / her e�a sl�are of interest?
MoRgagea/
M�� 1
inane m reootd is dAferent Nan ttut of aGP�N. IMicate Cebwc
Name of rtqttgagee ar mntrarl seUer �_
Pddress of nnrtgagee or mntract seder (nvn6ei end sLee4 �'. sfa�.
�������a
saeec �Y: ��a. �w z�v cma)
o� �pw�u �, �o� �, �,Y wn«
�,�cy�ma�a r—� .,--
�. �� �,��
COUN
Drdumon eppoveC In IM amount ar.
20 _ 20 _ 20
siqfanue m counb a�enur
o�l7�a
Eate ot appficatian
iG 33 3
es d Is Na epprrcant Na sole
legal p�''� de wmC1
,�J"Yes ❑ No
If owned with mmew�e oNer Nan sPouse. indimte xilh wlwm
20 _
m Vuestion: Mnua�y Asttssed
eel P(oPenY ❑ ���Y�
Moble 1-brtie QC 6
� l
__-"_'_ _'
Dra�r�er i�`O...a� � �......
333
Card NO . .....................
�IOQ,D00,�
20 � 20 —
��,�
'es ❑ No
oa� (ma�m, ear, r�tl
P�s
I/ We certify u�er the penatty of perjury that the above and foregoing infortnation is true and cortect anC Mat ihe applirant is a resident of IMiana and
owner I contract buyer ot ihe a(o2mentloned property on date applirabon is filed.
(o�me/s fu0 name Date (rnavWi. daY. Y��
A� t adtlrnss d app( t(w� � arM sLee; state, anQ3( �e) _ �[ \
�C \4J � � � ` C � � �
�son autlw�tretl Oy dWy exmted PoMer UAttameY � q' IC b1.1-12-0.7 - Data (monfh. dsY. Y��)
Add2ss of euNor¢ed person (numEer eiM sfree4 �Y, s��.