HomeMy WebLinkAboutMortgage_Wonnell^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
$tete Fortn C3709 (R71 / fi09)
� y�. � Presai6e0 Oy OeCartmeM of Lmai Govemment Fumnce
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INSTRUCTIONS: ,.�. Tr -�
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b be filed in person w by mail with tAe CounryAuditor or Counry Recorder o/ Ne county where tAe property isJorated.
FiNig Dates: i) Real PropeRy: Must file dunig Ne year lar which the deduction is sought. •. w County Audimr
2) Mob�7e / Manufac2red Homes not assessed as Real Property: Must fi7e dunng the twelve (�2) monfhs
6efae March 37 of each year the deducfion is swght �ounty Recorder
See reverse side (or addifional insMictions end quelificafions. ��f �
npp�cam (owrrer 9,p"�9t' see m�icbons on re`°'ig�de)
7, q�n year
what is his / her exaG shara of intuest?
tt name on 2wrtl is dRferent Wn Nat N aGG��j. uWifate Debw.
Name m morryagee «convarl
n,mea9a
sbm.
(numbar ad sdee; ctly, smfe. and LP ootle)
Ooes e�i�aN ov.n pnpMy in eny aNer I If yes, wha[
munryinlMana7 f-1 ., rl ..
20 20
, �� � 1
I! we cerUfy nder e nalry ot
owner / contracl bu Jhe afon
�(oxne
tll resitlent aEdress ot appGran[ (numbt
20
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3m�ol.7a�- __,P��`� �rn�,,.�_.... S
irdebtednrss unpaid as o( Morigage I ContrarY iMehtedness unpaid as d Is Ne appOmnt the sde
date of appGration legal w equitade or+�e(1
����� ❑ Yes ❑ No
rc awnea wim somewie other a�an sva�. ��e wim wi�an
is tM P�GQM in OuesOOn: Mnue%AactuC
❑ Real Roperty ❑ Armually 0.ssessed
20
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Wlgt Tavn9 D � G/uJ I O.• I l I�
4UDROR � �a5,�.�
the above arW foregoing intomiation is true :
property on date appliwtion is filed.
stata,
Dy IC 61.142-0J
nearess a aw,oraea x�+ (���,ner ane sfreec �: smfi.
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