HomeMy WebLinkAboutMortgage_Hix (2)��'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
�, .,; A FOR DEDUCTION FROM ASSESSED VALUATION
Slate Form 43709 (R8l 2-07)
•°�; �' Presaibed by �epanment of Local Govemment Finance �
ie a
INSTRUCT/ONS:
To be lled in person or by mail wifh Ne CountyAuditor o/ the county where fhe property is locafed. � � E C 0 8 2��$
Filing Dates: 1J Real Property: During the 12 monfhs be/ae June 17 0l Ihe year the deduc6on is to be e/fective.
2) Mobile Homes assessed under IC 6-7_ 7-7: Behvaen January 15 and Maich 2 0/ the year fhe deduction is to be elfective.
See reverse side /w addifional insWCtions and qualifications. ' �^�a� � y
� . ��1
=aoo-a�3.-rrr-oa�
I d indebledness unpaid as of March 1,
what is his / her ezacl share of inle2st?
m record is ditFaren� Ihan NaI of applicant, indinte below:
Name of rtartgagee or contracl seller
Address of rtaM1gagee or mntraG seller (number arrtl sheet. ofy. siatd. �vn0 ZIP croOe)
p olher oaner w hdUet of mort9age
of assgnee (numbei arM slreet, city, state, aM ZlP mde)
Does a�vs,.�,..T...`_....' __' _..— . ..,...__.
counry ii
�
I I We
, .
Drawer NO:.°?� ...•.•••
Card NO. ... �0, �5 �.........
� w7,�37. °°
penalry ot
r
�
If wmed with sameone
VJhat Tadng Districl7
20
Is Ihe appBpnt Ihe
spouu, indicate wi
BITpR
number
or equivae wmer,
❑Yes ❑ No
Is Ihe property in question:
❑ Real Property ❑ Mobile Home pC 61. i
Has ihis dedudion bean
tor wrrent yeaR
2� _
Date
uesletl on proparty
❑Yes ❑ No
�
iry that the above and foregoing informa6on is true and correct and thal the applicants was I were a resident of
ied property on March 7, 20
� Date (monfh. daY. yee�
street cifv. stafe.
Person aulhoriie0 bY duly ezecuted Power of Niwney a by IG Gl.l-t2-.0!
Atltlress of aulMaed pn�sm (nwrtber and streeL dty. sWte, antl LP oo0e)
..�,U, �7670