HomeMy WebLinkAboutMortgage_Whipkey"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ FOR DEDUCTION FROM ASSESSED VALUATION
S • State Fvm 43709 (R11 / 6-09)
,' w. � PresafEed by DePa�M of Locai Govemment Frence
INSTRUCTIONS: c a1n�h
b be filed in person w by maii with the CowtyAudifor or Counry Recorder o( the counry whe2 the property is Iocatetl.E P 4[ U UJ �
Filing Dafes: 1) Real Property: Musf file durim� the year /or which tha deduction is soughL � County Auditor
2) Mobde / Manufactured Homes rrot assessed as Real Property Must file dunng the twelve (12) months
6etore March 37 of each year Ne deduclion is sought �js �� Counry Recorder
See verse side (ar addrtional instrtxfions and qualifications. ^ v v _
t(o�mer� conva uyxr - see resLirb'ons m reve� sid . .
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I�i a�d istrirl . � : �/ legal tlesaipUon Record numEer Page numbn
� .�-i�1-�r9.- �.00-noa_�y�:=:o.�.7 aoo Y�iL
IAss�ed rd4�e of 2ai poperry az d Mortgage/ Contraa inde6tedness unpai0 as ot Morigage I Contract indeMedness unpaiE as o! Is Ihe aPd�t Ne sole
Ma�d� 1, armn year Mard� 1, w�rent yeer T date af appGralion legal ar epui�ade awne/!
I . Sn QOV ❑Yes ❑No
II ra. what Is his I her ezact share ot inte.restt
If ranie m �emrtl'a EiRrmit Nan ihat of aPp6�n; 4Wifate bekw.
Name of rtmrtgagee a mntract si
Pdaress m mortyagee «mnuaa
Name o1 assianee w oNer ovmer
sheeL �% state. aM ZIP cade)
or hdder M nwrtgage
ACtlress ot assignee (number aritl street �y. sbte, and ZIP cotle)
Is U�e D�PQrtY � Gunst[
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lll"a�rer.t\`p.
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Car� i\'O: .:'.,.y7i�p ..
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Does epplifant own popeny in any oNer If yes. what munt�? What Tarirg Disvirll )mpe+ly
munryinlMana? ❑ Y25 fararterrtY�. ..._ ❑ No
❑ No