HomeMy WebLinkAboutMortgage_Mason (6)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
__ _ FOR DEDUCTION FROM ASSESSED VA�� � T
� State Form 43709 (R71 / 6-09) � J
\ l Preuribed by DepartmeM o( La�l Gwemment Fimnce
� File Mark
�srRUCnoNS: ry �u�L� �n
w 6e filed in person or 6y mail with the CountyAuditor or Coun Recorder o( fh � e tY�, property is located. F� �
Filirg Dates: 7J Real Pmperty: Mus1 �ite during the year for which the deduclion is sQR�� �unry AuCitor
2) Mo6ile / ManuFacNied Homes not assessed as Real PropeRy A�s elve (12J months
6efore Mardr 37 o(each year the deduction is sought Counry Remder
Seereversesideforad 'ionalinstmctionsantlqualifications. . ��ggpN COUNTY AuDITOR
npp6cam (owrieRP`�� �/'Ea f�'C�bDnS ° . ) f� , n n .�.n . /'1 /� !� .
is � \ �y �mba / legal deSQi
"2�- O
eOvaluedreatPW�Yasof Mor(qage/COnt
1, ac�ent year Mard� 1. t
1�18� 6 �ILS ��IEf E%df2 5�13I8 O� Il1�BfE5I�
: on recotd "s tliRuent ihan fhat af aPW�^�. �ifate Cebw:
ot rtnrigagee or m�v`aG se0er
a cantraa
Name of atsi�Fee or atlw awner ar
naaressot� .,.�-�-�—� 1 �
��,.�,� ��
,- �AS�►�� � GG.� �
� �
� ��.��ISI
` ���L . • �
I/ We ceNfy under ihe
owner / mntrad buyer
Fir���
07-0Q3 �
Page
, ConttaC vWeb�eEness �mG� as d Is the �GO� tlrc mk
PGcation legal or equilade ov/rie(.+
❑ Yes ❑ No
If owned vrith mmeo� oNer ihan spouse. udifate wiTh whom
state, aM LP ooae)
mry.+ WhatTarir
COUNTYAUUROR
2�
Counry
ry ot perjulq� Viat the above aM
aforementioned property an da
. stat¢. 2ntl ZIP m
�s Pg�
by IC 67.1-12-07
person (numDeranO sneet �ry. sb(e, and LP rotle)
:S I�IC p10pCf�i 111 QIlG5LOf1: iU111U2�`/ iISStSSE�
] Rea� Roa�v � �M �
MoWle Hmie (IC 61.
fOf WIRl1� Y23i�
20 _ � 20 _
Date (rtronfh.
stetl m propcty
Yes ❑ No
20 _
infomialion is W e and correct and that the applirant is a resident of IMiana and
ion is filed.
Date (nmfi. daY. Ya�
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