HomeMy WebLinkAboutMortgage_Swan� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION �
y State Fwm 03709 (R71 / 6-09)
1' � Preunbed by Deparfimrit a( Laml GovemmeM Firence _
. File fJla
wsrnucnoNS�
To 6e ned in person w 6y mail witA the Co�ntyAuditw or Counry Recorder of the counry where the property is located. D�� �� � � U
Filing Dates: 1J Real Property: Musf file durrrg the year /or which the deduclion is sought.
� CountyAuditor
2) Mo6tie / Manufactured Homes rrot auessed as Real Property Must fJe dunng the nreNe (12) months R
bePore March 31 o/each ysar the deduclion is spqhL s.,, L�},?fEounry Recorder
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See e tora itionalinstructbnsandquali�ygtions. C'�BSONCOIitirv.�._.__
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LT�Si �
tt m. what is his I hu erav share oi intelrsi?
m rev[�Ye side)
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� i cmo-aa tr
am.nt year
tt rurt�e m maoN is dfierent Nan that of aD�. uN�die Eelow
r+ame ur mortqapea «mn,rau sei�u
nearess or morcgaqee «canvaa seoer �
Nama of asvgnee or ottm! oxner a ha10
naaress or assgnee (M,mce. ene svcrec
Does eppluant wm poperty in any oNe�
munry m Ind'ana? ❑ Yes
De�umon aPW�'v� ihe ar�ount of:
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signaare d Caunb Auancr
/ RecoN number Page num6er
l�'7-Oa �io a�/
es d Mongege I Contrxl uWebfeMess unpaid as ol Is iha eppl'irant the sole
date o( appOption legal n equilade amM
� ❑ Yes ❑ No
' owned wiN someone othe� than .'udi�ste wiN wMm �
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I (i l��
� � �- ��o �s
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.. �/�z(�� _� i � 'NR�21 Ta�tirg Districll
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20 I 20 I 20
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Dl�a��•cr \0........ ....
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1/ We certify under Ne penalry of perjury that the above and foregoing infortnalion is We and correU arW Nat the appiipnt is a resident of IrMiana arM
er I contract buyer of the aforementioned property on date appiiration is filed.
��' lp Date (+mnth. daY. Y��
� P�
antl stree4 aN. s+are,
AttcmeY or
person (num6craM sbae( ciry, sta[e. eM ZIP code)
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Datn ��, tlay 1'�e�