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HomeMy WebLinkAboutMortgage_Julian.! °•'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year ,. � FOR DEDUCTION FROM ASSESSED VALUATION Slate F«m 43709 (RB / 2-07) �' ; 1 Resrnbed by Depar�rrient d Local GovemmeM Finance File a �NSrnucnoNS: To 6e (led in person or by mail with the CountyAuditor o7 the county where the property is located. Fding Dafes: 7) Real Properfy: Dunng the 72 months belore June il ol the year fhe deduc6on is to be e/fec6ve. qn 2) Mobile Homes assessed under IC 64.1-7: Behveen January 15 and Ma�ch 2 0( fhe year Ure deduc6on i�� �/e�ti�41�� See ieverse side /or additional inst(vctions arrd qualificafions. Applicanl(owner � yfe'� number / legal� i a- �� -a a�-00% �l9-c�7 Remrd nu �� P� � 0[ v A rd paperty as N Mardl 1. anent yea� Mortgage �t2c1 i�ebteAness unpaid as af March 1. Is Ihe app5fanl lha sde legal a equilade owru fLR0f1� VC exacl shara af interest? m rcr,pd is AiRerent Ihan Ihal ot applinn4 inditate below: mrnlgagee m conUad seller rtwrtgagce or conuaa w aridsbeeL dty, state. erd ZlPmda) Dces applicant own property in any dher caunty in Ind�anal - - � Dra��•er NO..'..°.�.�...... 387U Card NO . ..................... �c'�-o v�.�� �►�'8��-m 0 .�S�Ob(� ❑Yes ❑No aM ZIP rode) ves. what muntv? . . � If o.w�ed wiUi sort�r,rone dher lhan spouse. ca,�ry zo Is Ue property in quesUm: ❑ Real Propeny ❑ Mobile Home (IC 6�1. Has lhis deducliwi been requesled on property iOf CURCIIi y22(7 ❑ Yes ❑ No zo_ � zo 1 I We certify under the penalty of perjury that the above and foregoing infortrwtion is We and cortect and that the applicants was I were a resident of Indiana and owner of the aforementioned property on March 1, 20 �nalure (owne/s NI name) - . Date immN. daY• Y��I � ,,.._ �_ . Q _ _ Q i�— n� D I �., loe N.9-t%< d by duy ezealed of Atinmey a by Address of aulld'¢ed person (num6er aiM sbeel. city, stafe, aiM ZlP code) o � �L_ �-( 7 ` 7 c7 Dale (manih, day. yea�