HomeMy WebLinkAboutMortgage_Weber"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS o shi vear
__ FOR DEDUCTION FROM ASSESSED VALUATION
�• Slate Fortn 43709IR71 / 6-09) �
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1NSTRUCTIONS: � C �
To be filed in person or by mail with the County Auditor or Counry Recolder ol the counry where the property is located. �� ��
Ftiirg Dates: 1) Real Pmperty Musf file durirg the year (or which fhe deduction is sought. CouRnry Auditnr
2J Mo6de / Manufadured Homes rat assessed as Real Property Must fiie dunng the fweNe ��OU TY DI�OJriry Remrder
befoie Maich 37 oleach year the deduction is sayht.
See reverse si0e foradditional insWCtbns end qualfications.
MBSnm (ownerormnvaa 6uyer- see re.wicpons m reverse side) A ..
i�'o-�.e� a-�
As�e.d Yalue d tral PopMY m M
MazU 1. anent ymr
Im. what is his! her e�ct sha�e o
tt rartie m �emd is dilleren� Oan tl
-�a-�i�-
W apP��C u�0irare cebw:
Name of rtnrtgagee or oontratl seller �
Address W mortgagee a contract se�er �numDer er
Name ot assignee or oUm! awnu or holder ot `mri4
A40ress ot ' ee (num0ei a� snee4 � slafe,
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Ooes eppli�nt am in any other
munly in InOena? ❑ Ye5 ❑ No
c6on approved in �he amount ot
20 _ 20
Rxo�d number Page num
. a a.'� c3,G / 7
iage I Contraa hdebtedness unDaid az d b Ne eG�t tha mk
>f apPfication legal a W�itable awneYt
❑ Yes ❑ No
omeoiro oNer than spouse. IMicate wtth wlnrn
is IM poperty in QueStiDn: M�weDY Assessed
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va�C7rte d Caunb AuEitw I Caunry I Dete (rtrorW. aaY. Y��
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I/ We certify u�er the pena of perjury N�ihe above and foregoing infomialion is W e and cortect and that the applicant is a resident of Indiana and
owner I mntrad uyer of the aforementioned property on date appiication is filed.
I^�ure (owiwfs hltl mey� � Date (month. daY. Yee�
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Pason auNOr'¢ed by Outy execuce0 Pwm+af Attaney w M IC 61.1-12-0.7 ' I�(�. �}: Y��
Atldress of a Wraacd person (number aM sbee4 u�Y. state. anAZlPcoda) .