HomeMy WebLinkAboutMortgage_Beard (6)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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. FOR DEDUCTION FROM ASSESSED VALUATION
� State Fwm 93709 (R11/6-09)
�' ,,,, f PresaiEeE by Departmerd d Local Govemmenl Fnaxe .
File Mark
JSTRUCTIONS: N
b 6e filed in person w by mail with fhe CouniyAudifw or Counry Recorder of Ne county where Ihe property is locatedo V F '�:
Filing Dates: 1 J Real Pmperty: Musf �le dunrg the year (or which fhe deduction is sought. �� County Auditor
2) Mo6�7e /Manufactured Homes rat assessed as Real Property: Must file dunng the tweHe (12J rtwn
before March 37 of eacA year the deduction is sought. Cou^b Rec°�der
Seereverseside/oradUiL'
. /�
. 7t�'r-a�-ci" o� co " l 'd' -
AssesedvaWeofrealpopertyasoi MoKqage�
Mardi 1. artart ymr March 1. c
�
It no. what a his I 1cer eaatl share oi intgest?
It name m 2md 5 dtlfuent Nan Nat of app9caN. InOirate [
Name of nvutgagee or mntrarl seller �j�
Address of mortga9ee or cantract se4er (n and streel, �
Name of assignee or oNu owner rn hdder o( mMgage
naaress ot assynee (n�rwer ane stre
Dces ePWinnt arm woP�' i ny oc'
munry in Indiana?
Yes
�
r
Osfutlion appfwc-0 m tl�e amount at
20
� - � � i
I/ We certify under Ne
owneG; contract buyer
RetorC numEer Page
a-oo o. 5� a-o a- � a o/ r y
iess unpaid as of Mongage / Confius mdeMcdness unpaid as ol Is Ne epplus
S JJ tlete of appGCatqn legal or epult
smle, arm ur cme�
slaffi. entl ZIPCOtle)
.�a-� 71 �° %
�f re�, �� �,�m
No
20 _ � 20
somewre ocner tnan spouse,
wnat �awn9 u�smn!
20 I 20
S
Yes LI No
Is U�e WoVeRY in 0�: Mnua�y Asscsxd
i� Real Roperty ❑ Anrarally Assessed
Drawer NO...o1.� I.�........
,. . :; .
�595 '
Car NO . .......:........:....
� �7,i 50. °°-
20 _ 20
Date (month. daY. Y��)
above aM foregoing in(wma�ion is true and correct arW that Ne appiitant is a resident of Ifdiana and
�erty on date applica0on is filetl.
state.
by IC G7.
ot auNa¢ed perso� (number aM sneet tlty. sYate. an0