HomeMy WebLinkAboutMortgage_Connor"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Township Year
:__ FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 609) r
' Prnsrnbed by Departrtrent of local Govemment Fuunce
File Mark
lNSTRUCTIONS: O
To 6e filed in person a by mail with fhe County Auditor or Counry Rernrde� of the county where the pmperty is located.
Fi/ing Dates: 7) Real Property: Must file dunrrg the year lor which the deduction is sought. � County Auditor
2) Mobi/e / Manulactured Homes rrot assessed as Real Property: Must file dunng the tweHe (12) months � �"�� r v
before Maich 31 of each year the deduction is srought ����1'' /C3�i�inty Recorder
See reverse side toraddifional inswcfions and qualifrcations. - GIBSON . q UI qA
Appfra o rwconbarl6uyer-ppe�es4i��sonreversesiCe)
Record number � Page
U/ �/ i/7 '/ 1O ' L`�lJ � Cr�-C/. V C1 '(JO� UV O� O
Assesed vdue cd real pmperty d Mor�� age / Conbac[ irMehtedn�s unpaid as of Mortgage / ConraC'uWebtedness unpaid as of Is Ne appli�znt the sde
Ma2h 1, axrerrc year Mamh 1, artent year date of apPBn' legal w equitaWe amef.P
❑ Yes ❑ No
If rw, what a his I her exad share of interesl? If ownea vriN someone ocher than spouse, indkate witli whom
If name an mcord s dAferent ihan Nat of appOcanl, indi`ate below Is ihe property in queeUrn: MnuaDy Assessed
eal Roperty ❑ Armually Pssessed
MoWle Fbme (IC G1.L7
Name of rtrortgagee a mntra`Y seller // ,� .
Irl'�.�.t.-�•_;.i
or oNer owner or hdder of mortgage
Adtl�ess of
Oces applitant own property in any o[her
munry in Intlana? � . _
oF.
20 I 20
ee; cM ��. aM ZfP code)
ZIP code)
- -/O .. .SSA�_._
If yes, what munqR What Tad�g DisG
COUN7Y AUDROR
20 20
Counry
�---�-..-..�M in NOOpl(V_
Di-a�ti-er NO..... a.�U
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Card i\'O. ..,.5���?
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— � Oa�e (mw�fh. daY Y��
I/ We ceRify under ihe penalty of perjury Nat the above and foregoing infomralion is We and cortec[ and Nat the applicant is a resident of Indiana arW
owner / contract buyer of ihe atorementioned property on date appiication is filed.
SignaNre (ovmefs N(1 �,_� Date (monfh. daY. Yea�
city; state, alM Z1P cotle)
�'t')o2 � 1S—o �.' �l�rc�
Persm a Wwf¢ed by duty ezeaited Power of Aaomey or by IC 61.1-1
person (nvmber aiM street �+N. slafe, aM ZIP crode)
�1 �
Date (rtronfh, day, yea�