HomeMy WebLinkAboutMortgage_Smith (30)""* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fotm 43709 (R71 / 609)
�' P2stri6ed by �epartment oi Loral Govemment Fliwrs
wsrrrucnoNS:
To 6e filed in person or 6y mail with fhe CountyAUditor o� Counry Recordar of the county whefe the p�operty is located. �
Filing Dates: 7) Real Property: Musf file dunng the year (or which the deducfion is soughl.
2J Mo6ife /Manufacfured Homes rrot assessed as Real Property: Mus( file dunng fhe fwelve (12) months A U
6e/ole March 31 of each year the deducfion is snught.
See reverse side for adtlifronal instructions and qualifrcations. •-�.
AppGgm(ownerwmntractbuyer-see mreversevCe) '
File
O��������yq tyAuditor
'County Recorder
'Oi�ri ' KeY num0er / legal deSaiDtio^ Rem�d number
' aG- -�oo-oo� 79i-oa7 �04
eE value of real qoper,y az of Mpr�q '�ge/ Convaa'v�tlehteCn�s unpaid as o( Mongage / ContraG'vWebieOness unpaid as of Is Ne a
1, armrt year Marrh 1, a�rrent yenr date o/ appfca Wn kgal a
�� no c� i
�i Iq. W�12� 6 �16 � i12f CYMY 5�13I2 Of Il11CIE5l�
If nane m 2coN "s S�Ferent than Nat o( aDp�'anf, mAinte Geb�r.
mort�agee ar mnbact se4er
� T F �U
W rt�atgagee a wntraG u0er (num6er and strcel, crty, stete. eM LP code)
Name of assignee or othel ovmer or holder of mortga9e
Adtlress of assignee (number antl streef, rdy, slafe,
Oces eOW��M ovm pfoperty in any other
munry in Ind'ana? � ..
someorre other ihan spouse.
numCrJ
Y� u No
Is ihe property in pues4on: MnuaAy Assesse0
❑ ae� anaenv ❑ a�,�Na�
+�oak r�a„e pc s
Drawer NO..°...�....�.........
Card i�`O. ....���..�..�.9..........
4Mat Tari�g D'¢Uict?
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