HomeMy WebLinkAboutMortgage_Clark (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_. FOR DEDUCTION FROM ASSESSED VALUATION
• State Form C3709 (R71 / 6-09)
�' ,�„ Presaibed by Departmerd ot LnW GovemmaM Finance
File Mark
wsrRUCnoNS:
To be filed in F�
person w by mad wBh the CounryAuditor or Counry Recortler o/ Ne oo�nry where the property is ted
Fifing Dates: 1) Real Property: Must file durirg the yaar /or which fha deduclion is sough[. nry ditor
2J Mobile / Manufadured Homes not assessed as Real Properly Must h7e dunng the hreHe (1 months ❑
before March 31 of each year the deduction is saght County Remder
See 2verse side for add�mpal inshur,(ions erid qualificationsn _ N � V
ro.
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� I/ We certify nder ihe
owner I mntracl buyer
6k (ownerSf�IDrre )
F ant ddres of appGCant
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PrJSm aWqi¢eE by dWy exeart
AdOras of authortreC pe�son (nc
)-OGY� • s3 �-c/�si6�ON COUN UD TO���
az d Mortgage / Conraa hMebteMrss �mP� as N Ls ihe aCP��� Ure sda
date W ePpfcation Iegal a equitable ownd+
❑ Yes ❑ No
�wnad wah mmewie aher ihan sDa+�, IrMkate wiN Mwm
w���
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Counry
is me woa�v �� a�,: a,�,enr wuessea
] R� ��m ❑ ��r �
a��r�nc�
Has inis eedudim Daen re9unsted m v�P�Y
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the above aM (oregoing infortnation is true and cortec[ ar�d that Ne applirant is a resideM of Indiana antl
oroceM on date appiiration is filed.
tiry, sbre, antl LP oode)
Pawer W Aticrriey or by
Sta�e.
Date (rnorvA. day Yae�)
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