HomeMy WebLinkAboutMortgage_Hawf""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C n , T shi Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
Slala Fvm 43709 (R70 /71-08)
� »„ / r�anroawwro��a�o�co.��mF�� JUN 4 Z�O9
INSTRUCl10NS: � File Mark
To 6e filed in person w by med with the CouNyAuditar d the county wfrere the poperly is located. /�%a ��ac�
Wirg Dafes: 1) Real Property: Must IHe during the yeer lor which the deducfion is sovght. �.. O'
2) Mob�7e / Manuladured Hort�es not assessed as Real Properly.� Must fi!e Oumg tlie hveNe (12J�g����t.� �ear
the deduction is sought.
See
AuesseO value of real poperty as d
Match 1. wrteM year
M ro, what is ha / her ezaq share d i�rte�s11
�rt
rertie m remttl
end QualficationS
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beb�r
cantrad se0er (rum6erand aticet of1: s�4 �� �0)
Name of assigree w oiher oxner or tdder tl mdtBaBa
d aaignee (iwwmber and sbeeC �+Tl: sb5r. aM LP c�dej
'�V"'�: „�
as
date
U wmed wit� someore alhar lhan spouse.
couNn nuwroP-
oaa� ��a m ma a�a�m a �
20 2� 2� _ 2� \
SgnaturedCourrtyAWilw Cou �
I/ We cerOfy under the penalry of per'ryry ihat the abave and foregang mfortnation i
owner / mntrad buyer af the aToremenfioned properly on tlate aDP��M1�n is filed. �
FiA rasident addkss d epp&ant (nunbrrard sbdt. city, sb�. arE LP oode)
%v�i S .3 so w ��.�y�tFoH 7��
Person aNharsed by duy emwbd Pwver dAtlomey or by IC &1.1-12-0.7
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rilabie orne(f
Yes ❑ No
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IS ihe V WaMY in 9uastian: AmuaOy Assasmd
� Reai Property ❑ Mnualy Atsessed
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Ca,���.
ho deCud:–' d on Praperg'
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�.N that Ihe appGcant is a resitlent ot InOiana and
Dale (rtronfh, daY•Y�i
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Date (rnanN. CaY•Y��)