HomeMy WebLinkAboutMortgage_Iunghuhn"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
,_ .; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fortn 93709 (R71 / 6-09)
�,�,� PresaiEetl by OeOaRmeb W LoW Gwemment Fi�nce
File Mark
�vsrRUCnoNS:
To be filed in °`m fl� ��
person or by mail wifh the CountyAuditor or Counry Recorder of the wunty where the property is loca
Filing Dafes: 1) Real Properry: Must file Curirg the }rear /or which tha deduction is sought. d���
2) Mobile /Manufactured Homes rrof assessed as Real Properly Must fi7e dun�ig the hvelve (72J s
before March 31 of each year the deduclion is soughG b e��
See reverse side (or addi(ional instnictions and qualifirations. D
Apa�. �nt (awne�ar conf+aU 6 see m reverse side)
I 1' \ n At� /s� ��iEd 1� _ � �, � 11 �im � �. �.�-.
nssessea v�e e re� prapsc,
IAarfh 1, wmn[ `Rar
ro, wha� fs his / tcer euct
name m
Name W rtrorlgagee w mntrsd seller
/ legal d�riplion
)S- �j,' a100-0D �•
Aor(qage / Conirarl indebtetl�ress unpaid a N
u�dinte
Mdress W �rort9agce or oontraa seAer (mmber ard streel, city,.sfate. aM>•° —ie)
Name at azvgnee w aNer owner �
�d�
Dces a�rvM wm propMy in any �
counry m IrWana? ❑ Yes
0pprovcd "v� Ihe amaunl oE
20 � 20 _
Signahrte o( Counb NEitor
2.p�� �
535�
� ��� �D� �
Wlro� Tarim� Oat+i��
arim�
39
Page number
btedness un7� as of �jQl�nt Me sde
�gal or epurtade av�R
❑ Yes ❑ No
spouse. iMirate with whom
15 U�e property in puestiDn: MnuaOy A55e55e0
❑ Real ProPertY ❑ Armually Pssessed
Modle Hort�e IIC 61.
U�a deductim Deen requesteE m p�aperty
urrent yraR ❑ Yes ❑ �
20 � 20
I I We certify under Ne penalry of perjury that the a6ove arW fwegoing infortnatlon is true and correct and that Ne appliran[ is a resident of Iridiana and
owner / contracl buyer of e mentionee mperty on date appliration is filed.
��aw�JQ rsluUnemq) Datelnnvvh.tlaY.Yaah
Date (monN. tlaY. Y��)
auNmrrzed persa� (number aM sbeo; cRy, statc, aM ZlPCOde)