HomeMy WebLinkAboutMortgage_Carter"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
; FOR DEDUCTION FROM ASSESSED VALUATION
Stata Fwm 93709 (R77 / 6-09)
S � Fresaioea ty oepar�ment o� taca� Governmenl Fuarce
File Mark
INSTRUCTIONS: ^��
To be fifed in person or by mail with (he CountyAuditor or Counry Reoorder of fhe counry where the poperty is bcate� ��
Filing Dates: 7J Real Pmperty: Must file durhg the }rear for which the deduction is sought. p' '
2) Mo6Ae / ManuFactu2d Homes rat assessed as Real Pruperfy Must fi7e during the fweAre (72) monrh.�
be(ore March 31 0/ each year the deducfion is sough[ Counry Recorder
See reverse sid (w addifional inshuctions and quali�rations.
AppGra^t ( r Po^tra�l buye� - see reverse sid� '' .� .
eo vawe a real poperty as
7, pmnt yPar
�il10. W�12� 6�16 � i1P10 'W2 5�13f8 Oi Vl(C251)
tt name on remrd is CiReren[ Nan ihat of appOrarrt, i`Mibte below.
Name of mwtgagee or mntrarl setler
Pddrea of rtortgagce or cmtrafi sWer
ownef rn hoWer ot mortgage
ier ard sheeG �: sbte, antl LP mtle)
Dces appfimnt wm property in any other
counry in Intliana?
❑ Yes
DeEUCtiw� apprwed In Ihe amount
�`L�'
I( yes. what munty.+
20 � 20 _ � 20
I/Wed
owner I
�
V �VV . Jv—C�.(� GI89�✓+tiv��.,:�.�wJ
unpaid as W Mortgage / Contract intlebteEness unpaiC as d Is ihe applinnt Ne sde
date of appGntion legal w equita0le awneR
❑ Yes ❑ No
If avmed wiM someo�re otM! than spause. iMi�ate wiih wlwm
Is C�e property in 0���+: �nua%ASSesud
❑ Real Property ❑ Armually Assessed
D,-1„���� �io.. �9........
� �vs�,5
. C:ll'(� �'� . .....................
� $ !0'4 � 'Y00 . �
s�a o� v�a�r
Yes ❑ No
20 _ � 20 � 20 _ � 20 _
� ICe,�r I�°�'"� �,D�,� I��`,�' �;°—I c�-c�
penalry of perj that Ne above and foregoing infortnation is We and mrteG and that ihe applinnt is a resident of Indiana and
�f Ne aforemerttioned property on date applicatlon is filed.
Date (monfh, day, yaa�
�
ffire,
FdOress af aWra'¢e0 person (number eM snee4 u�: sta�e, and ZIP
7