HomeMy WebLinkAboutMortgage_Hardiman (7)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_ FOR DEDUCTION FROM ASSESSED VALUATION
Stafe Form 43709 (R70 /11-0Bj
` � R'eulibad bY �VaM�enl d Local Gwernme� Finan�
INSTRUC770NS: F
To 6e fiietl in person ar 6y mad witli the CountyAWdor d fhe counly where the property is lacated.
Fi7irtg Dafes: i) Real Property.� Musf /de tluring the yeer fw which fhe deduction is sought. �U 1 q �
2) Mobde / ManuleUured Homes not essessed es Real Properly: Mus! file dun�g the IweAre (12) months be(ae M� 31 o ea ooyear
the deQuttion is saught
See raverae sde /or addkional insWd"ans and qualfications � ,Q��
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At5as5eCValtedieal asd Mar1pap e/ContadindeMedrressunpai0as
AWrJ� 1. auieN yea . /.lazrh 7. aareN yaar
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C fame m remd'c d�areN Uw� Uut of aOG�b.'udimb heM:.
Name d mwigagea v concrad se0er ��
Addrass d mortgagee or mntrad seBer ( rantl sfreeC tlh, sE
Name of esSignBe or otl�er amer tt hoNer of (roRgape
Address d�xip�a (iwmbel an0 strnaf. cq: ffi�, aM LP coCe)
Doas a7d�w�t ovm PopeM in ary alher H ym, Wu
couMy in IMFanai �" r-� '_
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Is the appfxanl ihe'sde
legal ar apui�ble awrre(�
❑ Yes ❑ No
b me poperty in 9�ation: AnnuaM Assessed
❑ReaiPfoparty QMnuallyASSessed
Mobile Flane (IC 6
raduested on pmperry
zo � za
I/ We certfy under [he penalty of perjury -. ...0 torega� mfortnatbn is true a� correci and Nat the appGCant is a resi0ent of Indiana an0
owner I mnVad buyer of �he aforemenibi.�, property on tlate apD����n is filed.
Persm aulhp'sad by duly azBaiOed Power o(Atbmey or by IC G1.1-12-0.7
oarson (numnaanewee�,
Data (rna�fA. daY.Y�)