HomeMy WebLinkAboutMortgage_KerrT" � �r-�.
.e=�•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n't To`Yr nship k vear
�,, .: � FOR DEDUCTION FROM ASSESSED VALUATION --� � i
State Fwm 43709 (R8 / 2-07)
�'';- '� Presaibetl by Department of Local Govemmenl Finance JA N 5 2009
File Mark
INSTRUCT/ONS: �j�R� ���
To 6e filed in person or by mail with fhe CountyAuditor o/ lhe county where the p/operty is located. -
Fding Dates: 1J Real Property: Dunng the 12 months befwe June if o/the year the deduction is fo be e/fecfiv616SON COUFITY 9�OITOF
2J Mobile Homes assessed under IC 6-7.7-7: Behveen January 75 and March 2 of the year the deducGon is to be effect� .
See reverse side !a additional instiuctions arrd qualifications.
see resfnctims on reverse
Ta�d isUid Key number / legal d ptbn Record number
�.a� � -. /� -. D3 -.3ao - ooa. oa� -D a 7 �� o�
0.�ssessed ralue of real popaty as of Marrh 1, ament year Morigage / Contrad iMeWetlness unpaid as M Maich 1, Is Ihe app6pnl Ihe sole le
artent year . _ � „
�me on
Name of mortgagee or conlract seller
SL3
Address of moM1gagee w cmVad seller (numberarM 4iaeC tity, sfete, end
Name of assignee a dher o.vner or
dicanl own propeny in any ather
Indiana?
❑Yes ❑ No
Deductian
20
amount
20
1 I We certi�/under the p�
Indiana an�l owner of the
�nature (owne/s7uJf narr�
by dury
Addrass of autha¢ed persan
•1wm.
Page number
❑Yes � No
Is Ne property in question:
❑ Real Property � Mobile Home QC 61.
Di-a�ser N�!� — / / � ✓
21P code) pr l. `� I-(� \i �•
..................... y
//-S; DO�. °� ��3- ��� -
It yes. whal counry� VJhat Texing uin�... �
forana�n ��„
❑Yes ❑No
COUNTYAUDROR
20 _ � 20
Counry
20 _ I 20
Date (month. day, yee�
20
Uat the above and foregoing infortnation is true and mrrect and that the appliwnts was I were a resident ot
DroOerty on March 1. 20 _
state, and
a�omey « ny ic
sfreel.
Data (month, dey. yea�
Date (manN, Cey, yee�