HomeMy WebLinkAboutMortgage_Brown°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou owns ' ar
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� FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (RB / 2-07)
�' � Presmbed by Department of Loral Govemment Filarrce C T O
File Mark
INSTRUCTIONS: `'�-r,� ���
To be filed in person or by mail with the CountyAuditor o/ the courrty where the piopeAy is located. �'�
Fding Dates: 1) Real Property: During fhe 12 months be/ae June 17 0! the year the deduction is to be elfective.
2) Mo6de Homes assessed urMer IC 6-7.1-7: Beriveen January 15 and Marclr 2 of Me year the deducti���� �If�14iaY A UDITOR
See reverse side /or additional insWctions arM qua/ificafions. �
m Ieverse side)
� Key manberlleg2
v�oveny as or n��a, �� ��
exacl share ot inleresl?
-� 9- `!d�-ocb.73/ -o�t
Mu�gage / Contraa indebtedness unpaid as of March 1.
wrtentYear ^ � ��
cJ
If wmed with sortieone ather Ihan
ihat of applican4 ��dica�a below:
Name of mortgagee or mnUact seller�'% // ,
C /`�.�
Adtlress or mor�gagee a oonUaa seller (rwmber and �
Nartre of assgriee aW�er mvner or hdder of mw�gage
naa�eu �r ass�ynee c�ea. e�a sneet cnr. �s�e. ana
ooes �w� � v�m �� �r ane.
�,my � i�aaret •
❑Yes ❑ No
Deduclion approved in �he amwnt of:
� � � �
Sigreture of Camry AudMr
dty, stafe. aM ZIP co0e)
�a,
�s. what counry7 Wh
COUNTYAU
ReooN number
a �� � n
❑ Yes ❑ No
spouse, i�cate with whom.
Is U�e property in quastian:
❑ Reai Prooertv ❑ Moble Hane
�oo � - 7�9i
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- "�'LQ. �(
0
20 20
��% �"'jy��• Q���.,�/^'7`
C � (O'
1 I We certify under the penalry of pe�ury Uiat the above and foregoing infortna��
Indiana and owner of fhe aforementioned property on March 7, 20
L�
oflLLlorney w by IC G7.1-12-.07
persan (numberantl street dty, s(ate.
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3� (o SO . o 0
Dale (manth, day, yea�
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