HomeMy WebLinkAboutMortgage_Brewer�^^n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
O FOR DEDUCTION FROM ASSESSED VALUATION
Siate Fortn 43709 (R11 / 6O9)
,' ,,,� 1 Presaibetl by �epartment of Loral GovemmeM France
File Mark
wsrRUCnoNS:
To 6e filed in Y b' N �Y P � h:
person or b mail with the Caun Auditor or Coun Recorde� o( fhe coun wheie the ro lo te
Filing Dates: 1) Real Pmperty: Must file dunrg the year Por which the deduction is sought. unty Audrtor
2) Mobile / Manulactured Homes not asseued as Real Pmperty: Must fife dunng the hveHe 2 m t
6efore Maich 31 of each year fhe deduction is srouqht. County Recorder
See reverse side foradtlil'anal insfructions and qualfications. �UN 2
M .(ownei w cmtra¢fB1ytr- see mshn-1;ore on reverse side) \ n_ 1 .� .
�� .
nssessea rdue3Fe� property as ot
MaIU� 1, ctme�rt yrar
rw, what k his I her eur2 share of interest?
If name on �d 5 Crflerent Nan Nat of aPP�^4 �irate bebvr
Name ot mort�agee a
AAdress of mongagee or mnbact seDer (number aM streef, ciry, slate, aM ZIP cade)
owner or hdder of morigage
Does aP�lipnt ovm properry in
munry in Ind'ana? �-�,
�. . . .
�. ' '
2� _
1 I We certiy under Ne penalry oi pe���.;-._,
own�r I contrad buyer of the afo�eme�oned
Address
"�
luly executed Pawer of AttqrneY a q' IC Fii.7-12-0.7
person (numberarid sbee; dry, state, aM ZIP code)
as of I Mon
Uate
as of I Is the applhant Ne sole
legal w equBable ovmeY.+
❑ Yes ❑ No
If awned with someone o�her than spouse, iridicate with whom
AUDITC
Caunry
Is ihe pmperty in 9uesUrn: Mnually /vu,ssed
❑Rea�Propero ❑.4nnua�rywssessea
`�3��� sus�,�-, � �
Q U�.�tJ r� /Y1 E:q-G l��F,� �% ❑ No
� a � �ss
Oale (mmth, tlay,
infortnaUOn is We and cortect arW that the applinn[ is a resident of Indiana and
ion is filed.
Dale (rtrorNi, day, yea�
Da[e (rtronN, day, yea�