HomeMy WebLinkAboutMortgage_Eubanks (3)"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
_ � FOR DEDUCTION FROM ASSESSED VALUATION
Sta[e Fortn 43709 (R71 / 6-09)
S � PrewibeE Ey DepartmeM of Lool Govemrtrent F�rcs
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INSTRUCTIONS:
Form fJed r7
To be fiied in person a by mail with Ihe CountyAuditor or Counfy Recorder of the wunty whele Ihe property is located. 11 �`� 1
Filirg Dates: 1) Real Properry: Must file dunng the year (or which the deduclion is soughL L j County Auditw
2J Mobde / Manufactured Homes not assessed as Real Properry: Must file dunng the rivelve (72) months ''/ '
betora March 37 of each year the deduction is sought. ❑ County�g�er
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See rev�rsa side 7w adtlitional insWcfions and qualifications. V pUD
I (owne�orcorroaa4uyer�se�resfn�onsmrererse "e � / ��nGOr1 -'JiiT�
a �. . - icev �ce, ���i � D . �U / _ Gb /. g�j % -� J- % p(UO %' P� � 3 �o
A�sed vahie d rea1 Vo�IY es d Mort9a9e I Contrarl rtde6ledn¢s unPaid az U Mwtgage I CrnSaf2 irMebtedness unPaid as of Is Ne eppl'rcant the sde
MarM t, cimtt ymr Marri� 1, artem yrar tlate of appGCation kgal w epuitade ameY?
I ❑ Yes ❑ No
tt ro, what ts his l her eraq share of inte`est? ff owned with someo(re other Nan spouse, indicate with wlwm
If nartre m n.mtl is Eiflerent Ihan Nat a( aPpGran; i�Wifa
Nartre ot rtmrtgagee p mntrad uller /
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Address of mortgagee u contraa seAer (numhu and sbe
Name ot ass' w g owner halder ot mong e
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AOarPSS of assignee (rvmNer ertl atreet �: sA�. and e
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Person ac.
Pddress of auUwr¢ed paw.
sb�. aM LP code)
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WAat Taring D'¢tr'u3?
couNn nuorcort
20_ 20_
Counry
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ie praperty in QuesUm: MnualyAsussed
Real Pivperry Q ArmualyAssessed
bloWle Hane (IC 61.
Has Na deduCtion been reQUeSted m property
(or airent YeaY! ❑ Ye5 ❑ i
2f1 � 2�
3oing infortnalion is true and correct arM Nat Ne applipnt is a residenl of I�iana and
pliption is filed.
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