HomeMy WebLinkAboutMortgage_Thomas (4)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
:r--
= FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 6-09)
�,.,� � Presaibed by Departmenl of Local Govemment Frence
File Mark
wsrRUCnoNS:
F Ih:
To be filed in person w by mail with fhe CountyAUditor or Counry Recorder o/ fhe counry where the propeM is focated.
Fding Dates: 1) Real Property: Must file dunng the year /or whicA Ne deduction is sought.
2) Mo6de / Manufactured Hwnes not assessed as Real P`operty: Must file during the tweNe (72) months
befo2 March 37 0/ each year the deduction is sought. ❑ Counry Recorder
See reverse side �w additional insfructbns arM quali�cations.
Appbcant(ow�,ctrcontrarlhuYT✓-seerest�icQunsmreve sitl - C.�.�•-t
�T� /7 1 °� . _ _ _ _
�Ta�y Oistr' ' I 1 Ke rwmber/ Id
� v �_� _� 3 _
a�a � d� woa as ot MMORqage / ContraC'udebtetli
Ma�di t. nvmnt year amh 1 artent year
� �
Ii ro, what fs his / her e� share oi interesi?
11 iurtre m recortl a Cifterent than ihat ol appikani, iriCipte Gelow
Name ot rrortBapee « cono-aa seoer �, .-.
A�EteSS oi rnotigagee «contrad seller
rnmer or
��.
er m rt�ortgage
� j �-� drna si
Does applitant own property in any oNu
munry in Indiar�a? �
❑ Yes
20 I 20 I 20
or
o .aio-oa ��B
unpaid az N Mortgage / Con;raU inCebtedness unpaiE as
date of appGfation
mmeone aU�er ttun spouse.
.s., '
,�y �� a
/l-yy��
20
20
Is Ihe aPd��t Ne =^�°
legal w aquipde ame�t
❑ Yes ❑ No
Is Me ProPertY in 4uesCOn: MnuaM Assesse0
❑ Real Properry ❑ Mnually Assessed
r.wtae ria,� nc s
Has Nk tletlutlia� Eeen requesteE m property
for ar2nt yea/? �._ �.
f��7
day,
20
I/ We ceNiy unAU Ne penalry of perjury that the above and foregoing infortnation is We and cortect ark Nat the appiicant is a resident of Indiana a`W
am I conUaci buyer of Ne aforementioned property on date applicatlon is filed.
�O%��%Y � ��) r� _ �� Date (month. daY. Yea�
and ZIP
Power of Attamey a by IC 6t.1-12-0.7
Pddress of autha'ved person (numbe� aiM sbeet �ry. sble,
oa�e ��m. aay, rean
W