HomeMy WebLinkAboutMortgage_Walden (3)'�� STATEMENT OF MORTGAGE OR CONTRACT INDEB�f� Township Year v
_ s FOR DEDUCTION FROM ASSESSED VALUATION 8
, State Fortn C37W (R17 / 609)
� f �����o�����F� FEB 2
File Mark
INSTRUCTIONS: C ,�J,Ir�
Form Aed wilh:
b be filed in person w by mail with the CounryAUditw or Counry Recwder of the counry where the property �s
Filirg Dates: 1) Real Property: Must file durng the year /or which Ihe deduction is sotyhL �o n q�d"ROr
2) MobBe /Manufaciured Homes rat assessed as Real Property Must fiIe du(���@td���7ri����TO ❑ ry
before March 37 of each year the deduction is saght Counry Recorder
See reverse sde for additbnal instpictbns and quali�ir,ations.
o ����� � �-07— �00 -oo� 3"7�-ad� Q / P���
ed vaAc d 2al yapMy d 6lortaaae I ContraaypQebteO'n7ess unpaid as ot Morigage / Contrad inCehtetlness impaid as d Is ihe applircani the sole
1, aneH ym Mard� i. arterrt ye�� OA SOO date of aPP�� iegal a epuBaNe wmel/
� ❑ Yes ❑ No
tlia.
Ii rwne m remid "a dAf�t Nan Nat ot appA�nt, rtd'uate bebw.
r+ame a rtnngagee « mnract sener �,q .
If owned with sameorre aher ihan spouse, i�ipte
Addtess of mortga9ce or mnbaG seAer (nurtiEer antl sVaeL �1y. sbte, aM ZIP coEe)
Nama ol assignea or dhrr owner or htlder of mortgaga
AdCr�s of ass's,g�ae (numDer aM atree4 �Y. sfafe, and LP oode)
Oces applimnt wm praperty in any oUer If yes, what munp? WI
munry in IMana? ❑ Yes ❑ No
ction approvad in the amount oF.
20_ 2�_ ZD_ 2�
I I we ceNfy under the p�nalry of perjJry that 1he above a fore9oing intwmaGw
owner I contract buyer of ihe aforemenGOned property on e applicalion is fiied.
(number aM streeC ary, state,
� �{li S S7
Pefsm authoraed by 0�ly
�
AOtlress W auNU'ved perso� (numberaM street �ry, sta(e, antl ZIP mde)
Is �he property in puesoon: Mnuaoy Assessed
❑ Real Property ❑ Armualy Pssessed
Modle Hmie (IC 6
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