HomeMy WebLinkAboutMortgage_Bedwell.r°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tow�ship Year
a _ '
FOR DEDUCTION FROM ASSESSED VALUATION ����
Sfate Fmn �3709 (R8 ! 2-07)
�� ..� Pr�mbed M Dapshmeni d Laal Go�emmerrt Finance
wsrnucnoNS:
MAY��� M�09
To be fiJed in person w 6y marl with the CourrtyAUditor W the cowrty whe/a tfie propel(y is bcated.
Fding Dates: 1) Real Property: Dunng the 12 rtwnths be7ore Jurre 11 d t/�e year the dedr,ction is to be eNecBve. �
2) Mobile Hames assessed wdei IC 61.1-7: BeMVen January 15 and March 2 07 U�e year the deduction is tv�ie�i�v�
See reverse side for addrtional insbucGons arrd qualifications. p�t
Y AUDITOR
Applicant (oxne! m mntrarl �i ei- re�rictlons m Faverse siae> n � � n
Kay nu�na. i ie�a� desairwo�
— / ^� � —
3R31 . QIIC(1� �f A{Of�0g0 � Ci011� i
arreN year
applicanL iMicate belav:
or cmlraU seller
Address of mortgagee or mnVaC seller (nunber and stree4 aty. sfate. ard LP cade)
Name of assigiree a Wia owner or hdder of matgage
PAdress of assigriee (number ard sLeet dty. steta. eM LP oode)
applicaN wm propertY in a�ry alha
y in Indare7
❑Yes ❑No
ap� ��a m u� �o�a or:
201Jq_ 20_
0
i.��.�-aa
btetlnesqs u�np.aid as af March 1. 191he e�
'� If wvned wilh sort�eme Wier Ihan spouse.
R�G� 9 � P� 9�
I�ItlI1l UIB SO�B �892� Of BQU112b10 ONTIC/}
�es ❑ No
idicate with whom �
peM in 9uestim:
PrupeAy � Modle Home pC G1
�
� ��.........
�1'�\\'Ci' \0•
)UNTY AUDR� I � O,(j, . . . . . . . . .
Card \O. .........
� 57, �cA-��
p— . .
Dale
�o
�
I I We certify under the penalty oi perjury U�at the above and foregoing infwmation is true and mrted and that Uie appiipnts was / were a resident of
Indiana and owner oi ihe aforementioned property on March i, 24
„cm�.P r�Rr.r � i � � � / o�e (monN, ear. r�A
dent`addresas oT appf unrber and sheel, �cd . st fa. eiM ZIP m
%/.3 ne0�8 , Q/'�i/f, rOr�.gfdnP.�
autlwraed by duy ez Pwrer otlLLtm�ay w by IC G7.1-72-.07
s6eet dty, state, eM ZfP mde)
.z'N Y�6y8 - 9 ��3
(monN, day. yaer)