HomeMy WebLinkAboutMortgage_Pollitt°^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n shi Year
FOR DEDUCTION FROM ASSESSED VALUATION �
Slate Form 43709 (R8 / 2-07)
S j Prasmbed by Department of Lacal GoeemmeM Finance
MM
Fle Mark
INSTRUCPONS:
To 6e filed in person or by mad with Uie CountyAudifor o/ the courrty wFiere the property is bcated. �
Fd'u,g Dates: 1) Real Prope/ty: Dudng the 12 monfhs be/ae June 77 ot the year the deduction is to be eflective.
2J Mob�7e Harres assessed (mder IC 6-1_ 7-7: Befween January 15 ar,d March 2 of Me year Me deductionN �(�D�70R
See 2verse side /w additional ins6uctions a� qualificafions. GIBSO _
�".�
Taung Distrid
.•�
real papaM1y u of MarB� 1. arrrltl Y�!
/ her ezad share af'urieresl?
It rrame m remrtl is diffe`enl U�an that of appirard,
Name ot morigagee or caNa�t
- uu ►. �oc i - �a /
COIIU'dfx Ifld@WBd112551111P31d 25 Oi M3lCh
r �. V�/V
I(wmed with someone
gee a oonUaQ seller (rwm6er and �reet dty. �ate. ard ZIP cade)
ar Nher owner w hdder of martgage ..
Address of assignae (mmi6er and stree; cily, 9afe,
Dces aPplicaM oxn propertY in arry oNer
county m India�a7
❑Yes ❑No
Deduction appmvad in the amwnt of:
20
Sigreture of Counry Audibr
�
N
�
cotle)
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� 1°� ��
5S7 .Q��� ���9
`!f`�,�i v�4.+iGK.Vv�U-
IR ��I IP��
5 '1
�s me app6cant u,e e �egal a. eyuiwYe wmen
❑Yes ❑ No
spouu, indicate with whom.
Is ihe praparty in questim:
❑ Real Property ❑ Mobile Home QC G1.
Haz ihis d�
tw airrenl
20
ues�etl on propary
❑Yes ❑ No
Date (rtanlh, day. yea�
20
I/ We ceNfy under the penalty of perjury ihat the above and foregoing infomiation is We and correcl and tha[ Ihe appGcanfs was I were a resident of
Indiana �nd owner of the aforemegponed property on March 7, 20 _
Date (mtx+th. daY.Y��)
address af applicarrt (num6er end:6ee; aty, stafe. aM
w by IC 67.142-.07
sheeC dy, sfate,