HomeMy WebLinkAboutMortgage_Zenow"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDN un ship Year
FOR DEDUCTION FROM ASSESSED VALUATION
Sfafe Fortn 03709 (R71 / 609)
�,.,, � PreuriEeA Ey OePaRmerrt oi LoW Govemment Fuiance
ile Mark
wsrRUCnoNS: N 0 V 2 9 Z F�, A�a �m:
k be filed in person w 6y mail with the CountyAUditw w Counry Recorder o! the wunry wAere the pioperty is located.
Fd"ug Dates: 1) Real Pmperty: Must !de durirg the year for which the deducLOn k sought �-�., � Counry Auditnr
2J Mobde /Manulactured Homes irot assessed as Real Prnperty Must file during the tweNe (�q�ri�pat7�s�S ❑
befae Ma/ch 37 of each year the deduction is mughG �f County Recorder
see.averses;deloradd"rtanarinsvucrbnsandque�ircariw,s. C3�0SON COUNTv
MP��� (a�e�or m�traC byrer' aee mstri�ons m raverse site)
�;a�a ee. i�yai a�au«� D- D�. 7 7 et - D o2 7 R�a r�
b "/ — � —�O D oZ0/O
rdue d� praperty as of / Cantrau Indebte0rress un0� as of MMgage I Contraa indebtetlness un7� as ot L��
uRnt Year 7, wrrent year tlate d eAP��
D O
: fs ha / hu eraU shara of interasl? rc awnad wiM sameane other ihan spouse, Indxate wtth wMf
m
ot rtiorcgagee or
ot mnG�t seDer (mmDai and sbeet ray, sm�, ard LP cade)
Name af essi�ee w oMer wmer or lmider of rtmgage
nea�ass m ass:yke ��umae.ena 4 cIIY. s+sre. entl
Draumon apqoved m tlm amount ot
20
Sigfatlira N Co�mb A�Wimr
� I I We certify u Ne I
- owner / mn yer �
Si6 (ownar3lu0narrre)
FWI rcsident a�s d appGc
Penon Ey dWy esi
r e �
Ma of authaaed x�
yes. what count�?
Real P(operty �
Yes LI No
Mm1aMASSesseO
�O� PN //
lMiat Ta�drg Districtl Fias tlus CeduUion Oeen 2QuesteE m Wopn+ty
�°�,"�' n �� n
Dra�ver NO.. r�p J.(�
20 _ 20 _ 20 _ 2� —
Cal'dQ NO. ........�.'�.,I �......
Counry -, �(q,�nN) ��'`�' � �
� ,..,
�enalry of perj � that the above and foregoing intwmation is true and corteG arW that iha appti�ant is a resideM of Indiana ana
�f the aforeme 'oned property on date application is fiied.
stare, end LP code)
Date (rrmlA. daY.