HomeMy WebLinkAboutMortgage_Garrison"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Counr
__,_ � FOR DEDUCTION FROM ASSESSED VALUATION
• Slate Fortn 43709 (R71 ! 6-09)
�S f Prestribed �y DepaRmenl of lnW Govemrtrent Fuance
NSTRUCT70NS:
To be filed in person or by mai7 with fhe CowryAUditw or Counry ReooNer ot the counry where the property i$_lerat�.-
FiTmg Dates: 1 J Real Property: Must file during the year fo� which the deduclion is soughG � �i r rt
2) Mo6Ae / Manufactured Homes rat assessed as Real Prt�perty Must file dunng !he fwelve (72J months
6efae Mamh 31 0/ eacA year [he deduction is s�uyhG C. �. M,.�,
See reverse side /or adU'tional instructbns arM qualifications.
� vdue d rrvl property az ot
PAarti� 7. amerrt Ymr
If ra, what a hit / trer ezaU share o
If name m remrE a diRemnt tlwn tl
Year
Z � CounryAuditor
❑ County Reoorder
Key n�mber / legal desmptbn Remrtl numbeJ Page numbel
aCv-�a-o9 -lo3-oa�t. �YY-o�7 a��7- �s3�
�rtpage / Cantraa irdebtedness unpaid a of Mortgage / Contrac[ IrMebteAness unpaid as d is ihe appfmant Me sole
Ma� 1, wrtent yesr date W av0��ation legal w Muita6le owne(!
5.�. DOO , • ❑ Yes ❑ No
belaw
morcgagee ar mnuaa sener /� _ Z
l�j a..L��i.-��
wncaa seuer �nrmoer em soee� crty, sra�, am ur caae�
name m assul�ee or amer owner w n
� o,���„��„��
�7 s,� s�
Ooes applirmn� o.m property in any ot
munry in Ind"ena? ❑ Yes
I
Deduction approved'o� Ihe amoum ot
q _d -ib
If yes, wha[ county?
❑ No
20 � 20 _ � 20
. 885'„1:: �
Whal Tati�g D'Strw
COUNTYAUDROR
eza
zo
re aher Ihan spouse, i�irete wi[
I5 ihe propetry in Ot
� Real Roperty
�
.
Dra�ver NO.... Q��.
....
Card Np, ,,,a5�p
, �, �. �............
I IOf M�Pw Jw.
LI Yes u •.
20 � 20
1 I We certify under the penalry o�erjury that Ne�ve and foregoing intortnalion is W e and correct arM that ihe applirant is a resident of Indiana aM
r/ mntrad buyer o e afo2mentioned pro rty on date appliption is fiied.
(o erY� Date (rrmtli. daY. Y��
F msid ot t(nume/�r an0 slreet a1y te, aM oode // —7
�n � �U /�� o ,' Ge d �i(. `1 /���
Psson authof¢etl Oy dNy erewteE Power of Almrt�eY a M IC 67.7-72-0.7 0� (rr,or,rn. day. y�
Pddress of aWiwved pe�son (number aM sbee4 �N: ��e. and LP oode) .