HomeMy WebLinkAboutMortgage_Smith (7)"`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
• Sfate FOrm 43709 (R71 / 6-09)
�` -� Presrnbed by Oepartment of Laral Govemment Frence
�"` File Mark
•iTRUCTIONS:
�
To 6e filed in person w by mail with the CountyAUditor o� Counry Recorder of tAe county wfiere the property is locat
FDing Dafes: i) Real Pmperty: Must file during the year for which the deductlon is sought � �� '
2) Mobde / ManufacNred Homes rrot assessed as Real Property Must file dunng the !welve (72) mon
6efore March 37 0! each year the deduction is sought. Coun Recorder
See 2verse side lor addilional instnictions arW qualifications. �
AppGnm (oww or buyer- sea 2s�rictims m re
C.�.
raAneo�so-m �y /IegaldesaiGtirn �ume� Y �UD
'Y _ I 7_ � ]_ .rJ�n -nnU �(o C'-f�a�l • ,., nN CouN � �
as�see�,eor�,�vasa - �nort
MB�M 1. amenl yPar Mart
If ro, whal is his / trer exad share of intelest?
1( �ame m recortl's 6fterenl than Nat ot appGCant. udi
Name ot mortgagee « s e� � � •
/ Con�ytract intlebceC�ss unpaid as of Mongage I Contra�Y uMebtedness unC� as of Is Ne sPD��rt� tne sde
urte/ �r�l � Cateo(aOP�tion � � Yes ❑ oN
Address of �mtga9ce w cantraq se0er (nwnberend sbeel cdy, sfa�, aM LP
Name of asvgnee or oing awner or hdder ot rtartga9e
AdCress ol ass'r7nee (num6ereM suee4 mY. �te. and ZIP catle)
Does applifant ovm pfoperty in any other
counry in Ind'ana? ❑ Y�
I
DeEuction approve0 tr� the amount of:
20 20
Sigrunne ot Counry Auditor
IS tlre ProGert1' in QueStim:lvunla�Y �
❑ Real Property ❑ Mnually 0.ssessed
DiSVict7 I Has ihis dedu�tion Eeen requesreE m WopeM1y
for artent yeaR n Yes ❑ No
COUNTYAUDROR
20 20 20
Caunry
+1��
daY, Y��
20
I I We certify under the penalry of perjury Nat the above and (oregoing information is W e and cortect arM Ihat the appiinnt is a resident of IrWiana and
owner I contract buyer of the mentioned property on date applicatlon is filed.
�nanve(o�ne/sfiLlreme)n r �(�.daY.Y�aA
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stare, and LP catle)
Pr�son autMr¢ed Gy OWy esewced Power al AvaneY � M IC 61. t-12-0.7 _ _ I Date (monfi. tlaY. Y'�a�)
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