HomeMy WebLinkAboutMortgage_Woodruff (2).+°•* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
�, ._ 4 FOR DEDUCTION FROM ASSESSED VALUATION �� ��
State Fwm 43709 (RB / 2-07) ,t
°�;- •� Presaibed by Departmenl of Local Govemmenl Finance S
File Mark
�NSrRUCrioNS: DEC 2 9 2008
To be (led in person or by mail with the CountyAvditor of fhe county where the property is located. �
Fding Dafes: 7) Real Property: During the 12 months be/ae June 11 0/ the year tlre deduction is fo be eHective.
2f Mobile Homes assessed under IC 64.1 J: Between January 75 and March 2 0! the year the deducSon �s�j be efl��
See reverse side for additional insWCtions aiW qualifications. // "���
- n � fii866iv ^^ �•�7V 4��n�Tna �
Applic.anl ( w mnVac(puye� - resJric}ims on r erse side) /)
�. /�l : /JS `f i
value of real property
�t no, what is nis I ner exaa snare ot imeresrt
�me on retard is difterent Ihan Ihal of appiicanl, irMirale below:
Name of moriga9ee or contract seller
� --
Adtlress ot mortgagce or oonuad sNler (numberen reet. dty. sfate, arM ZlPcrode)
Nartre ot assignee w oU�er ax�r o� hdder ot mptgage
Addrass of assignee (number eM stree(, city, 9ele, eM ZIP cade)
Daes applicarM own propeM1y in em/ aher If yes, whet countyt
counry in Indiana?
❑Yes ❑ No
Dedudion
20
SynaWre ot
amount of:
20 _ � 20 _ I 20
as
It mmed wM mmeane
Tax
Rem�d number� � Papa numbm
1, � Is Ihe app5cant Ihe sole legal w equitade ameli
❑Yes �No
spouse.
Is Ihe properry in quesGon:
� Real Property ❑ Mobile Harie QC 61.
�r7' ���—
C�D�2u�' � Ro►�n�0 iZ
R�� ��
20 _ I 20
�ate (monN,
� �es � NO
20
I/ We cer6fy under the penalry oi perjury Uiat the above and toregoing intortna6on is true and mrrecl and that the applicants was ! were a resident of
Indiana and owner oi Ne aforemen6oned property on March 1, 20
���.naa.,w�er<6�x ��i � Dale (mmth, tlaY• Y��)
Person aulhodzed by duly execNed Power
Address of aWhaaed persm (numDer an�
cilr, stat� IP
r or by IC 61.1-12-
aty. state, and ZIP code)
%(j
(manlh. der. r�n