HomeMy WebLinkAboutMortgage_Griswold"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
, : FOR DEDUCTION FROM ASSESSED VALUATION `
• S�ate Fwm 43709IR71 / 609) (/
�' ,�,. � Presaibetl M DePartmenl of Laal GovemmeM Flnance
File Mark
INSTRUCTIONS:
Form
To be ned in person a by mail with the CountyAuditor or Counry Recorde� of the counry where the property is
Fitirg Dates: 1) Real Property: Must file durirg tha yearlor which fAe deduction is sought. Auditor
2) Mo6ile / Manufattured Homes rrot assessed as Real Property Must file dunng the hveNe (1 onths
6efora Maich 31 0! each year the Ceduction is sought. ❑�.Counry Recorder
DE 4 uw
See reverse side for addilional instructbns end qualifications. � _
sida)
@openy as of
ar�mt year
tt ro, what Is Itis / her exaa shara o( intr�rst?
Ii name on remE's QRermt Uan Nat oi app6CaN, u�dk2t8 belov`
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G'�Plslvo�Q, �l,ec
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tt awned with someone oNer tl�an spouse, UMi�ate with whom
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aoio - � s� /
anA
� 7R,�e W N ►� , w K iace
7y Euly exearteE Pawer W ACaneY a M IC 61.1-12-0.7
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m equitade owrt�e(1
Yes L1 No
Is ihe property in Question: Annu¢Dy Assessetl
❑ Res� Pooa�v ❑ �^��N �
nt year?
❑ Ye
zo
Date (rtWh. daY• lea�
� P�oP�'+�Y
❑ No
2� _
hat the applipnt is a resident of IrWiana arM
Date (monfh, daY. Y��
o� t,�m, aar rean