HomeMy WebLinkAboutMortgage_Bailey (3)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun sh' r
>_ FOR DEDUCTION FROM ASSESSED VALUATION
• . :• Sfate Fortn 43709 (R71 / 6-09)
`�w � Presai6ed Ey DepaMierd o1 Lod GovemrtrerC Finaxa
File Mark '�UjU
wsrRUCnoNS:
To be filed in person w 6y mail vnth fhe CountyAuditor or Counry Recorder o/ tAe county where the pmperty is located. F ���
FiNrg Dates: 1J Real Property: Must file dunng the yrear /or wliich the deduction is sought. Cou ditor
2) Mobile / Manufadured Homes rrot assessed as Real Pmperty Mus! file dunng the twefve (12) months ` ,s�,
behle March 31 o/eacA yearNe aeduction is soughf. � �GCounry fY"emrder
i70F
See reverse side fa additional inshuctions and qualrficatiars. GIB
AoEGraN fowrerm contra� bwer- sEi ms0i�tans m reverse sitlel
a�a ,aa,e a re� �, �s m
Ma�d� i, armnt ym
tt ro. whal ls his / her ezxt shara
nnrtgagee or mnUad se4er
� - c.�- �i. ..r - �
Mortga9e/ ContraG intlebtedness unpaid az U Mortgaqe /
MamJ� 7, artrnt year tlete of apF
Pdaress W rtnrn)a9ee a contract se�er (numbrl and strce;
Name of assignee v Wrer ovmer or MNU of rtiork7age
AGdres9 O�
•Lv"=�^�� �
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shee4 �; slate,
U No
ao�o
ll��1„ �,- �o ...................
c��-� �o. .....5�90.......
� � 155,gyG.00
.,..��, �� uie atorementioned pm
� Sl9renue fowner's MI iro \\ (7 . A
Pason auUar¢ed Gy dWy exew[etl
aM LP code)
/6 � l)
unpaid as d Is Ihe app0ont tlie sde
� legal w eQUi�ade axne(/
� ❑ Yes ❑ No
tt owned with someorie oNef ihan sC�. ind�te wflh whan
�� P�P�Y in puesiion: MnuaDy Assessed
9U Real Roperty ❑ ArmuallyAssessed
� �_ d2.,/6
�ISbILii iia5 i�16 dEdU�C
(ar airent yeaR
COUNTYAUDROR
zo zo
Counry
�
�eqU¢SICd On propeity
❑ Yes ❑ No
Date (month. daY. Y��
F.��
__,,.t and (oregoing infortnalion is W e and cortecl and that the appiinnt is a resident o( Indiana ard
perty on date application is filed.
Date (monlh. daY. Y�A
end ZIP oDtle)
person (number aiM stree4 �}; sb(e. arM ZIP aotle)
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