HomeMy WebLinkAboutMortgage_Birch^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
:. -��
= FOR DEDUCTION FROM ASSESSED VALUATION
- • State Fortn 43709 (R711609)
�' Presvibed by Departmenl of LaW Govemment Fnance
�"" Fi
iVS7RUCT10NS: F� �� �:
To be hled in person a by mail wifh the CounryAuditor or Counry Recortler o/ fhe counry where the property is locat?� 1
Filirg Dates: if Real Property: Must file during the year for which the deduction is sought. jVIAY i��� Counry Autl'wr
2) Mobile / ManufaUu2d Hanes nof assessed as Real Pioperly Must file dunrrg the hveHe (72) months
before March 37 0/ each year the deduction is soughf. C, County Recorder I
See mverse side for addifional instruct'uns arM qualificafions.
qppGfant(ownaro. t_buyer-seelesvirtiw�mrever3ajcieer G�gSONCOUN
number l le9al
� . ►o_r
h15 / hPf GYdd Shd2 OI III2BIP5t�
If rertre an rcmd is tliRet�t N3n �hai
Name W rtprtyyy¢e ar mn(+ac� seller
-3c�4 • Cl�o . 74! - o
I Contrarl indebtetlness unpaid as of Morl
Addrea of rnvtgagce or mnbarl s�er (num6u end sveel, crry, state.
or otlrer awner w hdder of mMga9e
of assi9nce (num6er arM stree4 �y. stale.
Dces a�imnt am praperty in any
munry in IMana? � ..
ction apprm2d in Ihe artiount oF.
20 20 _
someo�re
I If yes. wha[ count�ll I W�at Ta�dng C
No
couNn nuorrorx
2o zo
_ __ __�4'
RecoN nuy�per I Page numDu
25 OI IS NC 8pp11(�nt Rie SW¢
legal w eWkade wmeN
❑ Yes ❑ No
wilh vrtam
�_ � _"`� �"
�i��
�ao�a-►95i
�����o��
CSI, Computer Systems, Inc.
866-9I3=1160
I/ We certify under the penalty of pe�ury thai the ahove and foregoing infortnalion is We and mrrect and ihat the applirant is a resident of Irdiana arW
owner I conVact Duyer of ihe aforementioned properry on date appliration is filed.
nvawre (a e(s hA rumel r. Date (nMfh. deY• 1'aa�)
�
zed by tlWy
sbeet, dry, sta(e, and LP code)
61.142-07
person (numberarMStreet, ciry, sYdte, aM
�/•
r,. I Date (monu; daY. Yes�