HomeMy WebLinkAboutMortgage_Parke (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T sh r J
__ + FOR DEDUCTION FROM ASSESSED VALUATION
• Sfata Form G3709IR71 / 609)
�' � Presvibed by DepaMreM of Laral Govemrtrent Firence
�e a
INSTRUCTIONS:
b be filed in person o` by mail with the CountyAud'nor or County Recorder of Ne county where the pmperty is located.
Filirg Dates: 1) Real Properry: Musf file dumq fhe }rear /or which fhe deducfion is sought �q �, i�p�
2) Mobile / Manufadured Homes rrot assessed as Real Property: Must file dunng the hveHe (12J monthsG IBS N U N�� ryU�Qle�r
6etore March 31 of each year the deduction is sought.
Sea reverse side (or addiLOnal insLuctbns eM qualifications.
1 or buyer�see ' m re�erse side)
'"��1` �z o , ��e.,�. r���
I ralue a( real
aamn[year
rc no,
Cer / legal drsviption /�/�
� _ � ��%�L
ge/ Contraa IntleEted�s unpaid az of
M 1. artent year
nane m remtl a AiRaent Wn Nat of appGranf, md'xate Gelow:
Name of rtqrtgagee or mntraU seller
anaress m rtnrt9a9ee « ca,aa�l
Name ot assignee w mhu owner
nmress
we�c
Does apqimnt own Wo7�Y in any oticer
couivyinlntlana? ❑ Yes
Detlurdon aPW� "u� the
20
Sig(anae of Cmmb Audimr
�y. �re.
Remfd number
iitade ownef.�
Yes ❑ No
(e P�Gen1' in 9uestion: Mnua%AssesuO
Real Property � ArmuallyAssessed
�9�e n �,I �VYn`�% l�
te antl Lqpodel � PA r� �- G
� AN
, �.,����n �Q� R�a ur� G "�`� r
No SUSP� G �k-�'
a��� - ��ya
�_ � p_ � _ � p
. [O�
� reo��a d+ w�r
20 _ 20 _
Oate (monfi. daY l��l
I/ We cerOfy under Ihe penalry of perjury that Ihe above arM foregoing infortnalion is We and mrtec[ and that the applinnt i5 a resident of IrMiana arM
owner f contrad buyer of the aforememioned properry an date appliration is filed. �- ��
� Ftill �SiOpppent -a�Etlfecss of a t(numeerantl sLre4 �: �re. Z1P m
�, '�c� r'i-i c e � � i N�
Person auNw'¢eE by Eury execute0 Pov.+i of Atmrney m by IC 67.1-12-0.7
yWraaed person (number and sbee; dry. state. an0 LP mtle)
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1-13—II
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