HomeMy WebLinkAboutMortgage_Hudson (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
� FOR DEDUCTION FROM ASSESSED VALUATION
:• Stale Fortn 43709 (Ri1 / 6-09)
� f Presaibed by Departmerd oi Local Govemrtrent Frence
��� File Mark
asrRUCnorus:
To be fiied in person or by mail with the CountyAUditw or Counry RemNer of fhe county where Me property is located. F� �� �
Filing Dates: i) Real Property: Must file dunng 1he }rear /or which the tleductbn is soughG � �
2J Mobde /ManWactured Homes not assessed as Real Property: Must Ae dunng the hvelve (12) monfhs
befora Ma�ch 37 o/each yearthe deduction a swight.
See reverse side for additional inshuctions and qu lifications.
Appfrant(orner 1raUbuYer-seer�trirLbns re rsesitle) �! . ./1 � 1 .
7nJR�f�T��
d
m
�(110. W�ldi 6 h15 ��12! 0%dU 5�12R O} Ill}Cf25I�
It name m tcmd is tlirterent Ihan that of appl�n4 4Wifate Debw
Name of mongagee u contract seller ��
Address ot rtwrtgagee w contracf seJler (numbnl and slreet, ctiy, state.
Name of asti�ee w other wmer rn holAer of mortgape
Address of assegice (num6er aM stree4 �: slate,
pces appliUN Own prapehy in 2ny o�her
munry in IMana?
❑ Yes ❑ No
Iuctlm app�oved'c� tlre amount oE
20 20
sfynawre a co�u,b adacr
I/We
JU�1T}I q
az N Mortgage / Canua
Eate of appfifatim
�a
rc ownea wim somrane mtw� than spouse. iMkate witF, M�rn,
C� Ar� y L �1u,osv,�
// � ��/
20 � 20 �
Cwny
Yes ❑ No
15 tlM WbPertY in Vuestion: MnuaOy Assessed
❑ Real Property ❑ Nmually 0..�sessed
Has Na deductia� been re9ursted m P�W�Y
�W�� ❑ Yes ❑ No
r.i��
oa�e (.mw,, ear. y�r�
2(1 _
under Ne penalry of perjury ihat Ihe ahove arW foregoing infortna6on is W e and correct and that ihe applit�nt is a resident of Indiana aM
act buyer of the aforementioned pmperty on date aDDlication is filed.
s hN ^ me) � 4/ � Date (monfh. dey, yea�
i "
and 5heef. rity, slate. end ZIP code)
Ey tluh/ executed Po-wef of AttomeY a M IC 61.1-12-0.7
Pdtlress d aWw�'vpA person (numDer aritl sveet ary. state,
daY•Yea�