HomeMy WebLinkAboutMortgage_Upchurch"^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
s�ce F«m aa�ae �as i z-0�
�' f Prasa3ed by Departmenl of Laal Go�ammerrt Firance
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INSTRUCTIONS:
ro aa mea r„ �,�o� w ny maa Wan ma cou�nya�mra� a rna �o��rry �,a� ma P,o�ny �5 io��ea. M AY 1 5 2009
Fding Dates: i) Real Property: During the 12 monMs befare June 11 W tlre year the deduction is to be e/fective.
2J Mobile Hames asseued urrder IC 6-1.1-7: Behveen January 15 and Mam.h 2 ot Me yea� tlre deductim is to be e/fec6ve.
See reverse side (o/ edditional insWcb'ons end quaGficatinns. �� �,/
/Sa+�
by'er - me
�r � m tdard� i. a�ran y�r
e�mct share of inlerest?
Nartre of rrorigagea
side)
/
nddrass ot monyagee «oonhaa se��er (nwnee. and streeC dry, srare, ane z�P cnde)
u aUier owner w Mder af mor�gage
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�� � � v�wem � a�y wn«
❑ Yes ❑ No
Deduction apprwed in Ihe amwnl of.
8"a-aa i
� u�pad as of nw�, i,
fa�d
41B30N COUNTY AUDITOR
Reoo�d number Paga number
am 9 a6a<
�s ine app6fant uie sde �ega� or eGUltade w.nen
�'es ❑ No
sPouse. uWicale wilh whom
Is the properry in questlm:
��e Pmperty ❑ Modte Hane Qc 61.
Dra���er \0..��•�•........
�s-��� aoa� .. 4��,�,
Cal'C� �O . ................. ❑Yes ❑No
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20� 20_ I 20 I 20 /�� �\
�reWra of Camry Auddor /
1/ We certify under the penalty of perjury ihat the above and `' /� �1 �, �� \\.
Indiana and owner of ihe aforementioned property on Marct�, �\ �� ��
U �—
C\�5� a Z� w
Person aiAhor¢ed by dWy ezewled Pwvei dlutartiey or by IC G1.
pe�son (num6eraMSfreel.cdy,sfate,antlLPwtle)
20 _
Date (monfh. daY. Yea�
20 _
tlie appGrants was I were a resident of
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. ��-l��i �
oate (mmm.