HomeMy WebLinkAboutMortgage_Camden^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
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FOR DEDUCTION FROM ASSESSED VALUATION
� Sta[e Fvtm C3709 (R11 / 6-09)
S Presaibed Ey DepartrneM of Lxal Govemmenl Frence
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�STRUCTIONS:
To 6e (led in person or 6y mail with the CouniyAUditor or Counry Recorder o/ the county where Me property is located.
FiTing Dates: 1) Real PmpeRy: Must fite dunrg the year /or which the deduction is wught.
2) Mo6i7e /Manufactuied Homes not assessed as Real Property Must h7e dunng the twelve (72) monfhs
6e/ore March 37 of each year the deduclion is sought.
See reverse side fof addiLOnal instrucfions and qualifications.
AppGrant (owneror G 6uyer- see resfictions on rev sitle)
n o' Key �oer i�si e�c�
,�,� i; .� �i . i �.n c_!mn _��n.�4.�-h� 7
ntam� i. anrm yrar I nw� �, a�
I( ro. whal ¢ his ! her exxi share of intrlest?
If name m mmN a Eifleren� Nan that of appGdn4 ��1e heb�r.
Name of mortgagee ar contraa see�eer �/�/{�J
/
Address of mo�t�agee m m�tract seuer (nvmbrl and snee; ray, 5ate. erN ZIP coc
Name o� assignee w other owner or hdder of mortgage
Addrass of asagnee (number aM streef, dry. 5/ate, and Z/P code)
Does apptimnt w.n property in anY oNer If yes. whal cwnq/.� �—
munry InJnCiana? r-i . _ r-� .. '
amount
2� _ I 20 _ I 20
unpaid as d Martgage / Cmtrar2 intlehtetlness
� EateNaGPGptim
If owned with somearre ather Ihan spouse. u
Township Year
File a
FE 7� Z��ntyAuCBnr
❑ nry Recorder
C....'.
N COUNTY AUDITOR
Remrd numbrl Page number
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unpad as d Is e applirant Ne sde
legal or epuilade ownrl�
n Yes n No
� V�P�'nY in Vuestion: MnueOy Assev.M
RealRopertr QlvmuallyAssessed
Mohile Hane (IC G7.
w_. r_�.. r.....Y.� .i.uY ��.:...wd...�.,.. nm...,.ques[ed on prOpelty
.... � Yes ❑
DCa„��r N�......ao� a
�a,��,�o....l.D..a�......:�. -�
Sig�uwre W CamN Autlitw I t;wnry I uate (mmm, aay, Yea�
I/ We certify urWer the penalry of perjury that the above arM foregoing in(ortnation is true and corte�Y and that ihe appliran[ is a resident of I�iana arW
owner! contracl buyer of the atoremerttioned property on date application is filed.
Person auttnmed Oy CWy ezecuted
Pddress of authoraed peison (num.
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Date (monN,