HomeMy WebLinkAboutMortgage_Dunn (2)""+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ + FOR DEDUCTION FROM ASSESSED VALUATION
• S1ate Fortn 43709 (R71 I609)
� / Prewibetl PI ��(rt oi Lxel GovemmeN Frarr<
wsraucnoNS: ped
To 6e filed in person or 6y mail wiN !he County Auditor or Counry Recorder o7 Ne counry wheie the property is located. �� 1� � �0
Fitirg Dates: 1) Real Property: Must file durirg the year /or which the deducfion is sought � j Counry Auditor
2J Mob�le /ManufaUUmd Homes not assesced as Real Property Must fiie during the tweHe (f 2j monNs ❑
before March 31 of each year Ne deduclion rs soughG R��
See reverse side for additiona/ insfmcti�ms and qualifications. ___
D�i�q Key �wmOer / Iegal tlesmD� Rem numbu P mbv
CL� l�- �- /- 3- Uo , UO o. /�>'- O� 7 �0 /G ��7�
As�ssed rdue d real paperty a d Rbrtgage / Conbau IntleOted�ss unP� az N Mwigaga / Con� udebtedness �mpaid a d Is Ihe aOP�t the sde
MarCi 1. pmnt year Ma�U 1. wrrent year date of eppOCation legal w epuita6le owne(?
❑ Yes ❑ No
n �o. vma� �s na i n� �a � or �i�n
rartc m ramtl s Srtterent Man Ihat
mortgagee a contrarl seqer � /�
/
d rtnrtqagce a mntracl se0er (nunbe� and sfreet ray, sbte, aM LP mde)
rlame m assi�ee w�i wn,e� a naaw m nbnga9a
AAtlress ot assignee (num6er anA atree4 mY. �fe, arM LP co0e)
Dces apptinnt rnm 7�D�Y in eiry ahef
munty in IMiana? r.-� "
�o _
sy�n� w c,�i
� u we rury �
owner co tr.
j( s'° i
�
( ` FuA �NMg�
yU `
Prfson authar�tl
anroura
20— � 20—
penalry of perjury that Ne above arW fo
of ihe aforementioned property on date �
�,�a �.anmmeY«cy ic
person (numDerarMStree;
�
wim somewie oHmr Iha� spouse.
� O�Pert1' in puestion: MnueM AssesseC
R221 PfoPertY � Nmua�Y Ass�s�
a�oa� r� nc s�.
Nas Nis tletluaim Daen reQUesir� m propGty
far wrrent Y?�? � Yes ❑ I
.
�� � �
Q.� O�.
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Dra�rer \O..
y$7a....... - —
r . . . . �. e�Y ,�n
Cai d� � 5� � 30•`�0 �
_.. v � ue and cortect and Mat the applicant is a resident of Irdiana aM
�lidtion is filed.
o�� c,�m,. e�y ,�n
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