HomeMy WebLinkAboutMortgage_Coats.� �'�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
,....
FOR DEDUCTION FROM ASSESSED VALUATION
State Fam 43709 (RS / 2-07)
S � Preso�bed by DepaNnent of Local Go�emmenl Firia�e
INSTRUCTIONS:
To be filed in person or by mad wifh Me CountyAuditor o/ the cou/rty where the property is bcated.
Fding Dates: f J Real Prope(ty: During the 12 months befwe June if of Ure year the deducSon is to be effective. 1,���
2J Mobde Hames assessed under IC 61.7-7: Behveen January 15 and March 2 0( the year the deduction tfllQ�6AGe1���8
See reverse side Ior additional insWc6ons and quali(rcations.
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rant amer or 6vye� - m rave sd /' '(C —�
�w c 1 �.�� � �� �i�, .,, l�� .(l'���N ��'}._ �
Ta�u i' Key num / legal tlesrnptqn
b—I i— �i — oI—ao1. �
��a v�ue or reai a�w�r az or n�m� i. amem r�� n�«�aye i com,aa ma�xeaness unv� es m n�rcn i,
wrreq4year/.�� � ni ' .
.�.
share of imercst?
IIf reme m recwd is dilierant Ihan thal of applican4 ��iote below:—
Name of mortgagee or mnUacl seller
Address of rtaAgagee « mntracl seller (number aM 9ree4 c
Nartre of assignee u alher owner or holder af mortgage
Address of assigrree (rnmber arH sLeel. city, state. aM ZIP c
Does applicaN own poperty in arry olher
courty c� Indana?
❑Yes ❑ No
DeduGion apprwed in Ne arna�nl of:
20 '�_ 20 _
SiarvWrctoi tvAUddor /1 i
res
20
� 0�' � c.�- u�
Is Ihe appfi�t Ihe sde legal a equiUWe owneR
❑ Yes ❑ No
spouse, indicate rrith whom.
is Ihe WopeM1Y in 9uestim:
---- -.._ - -I a�� Prooenv O nAabile Fiome oc s��. t-
Dra�r•er NO.o�i�0.:..�.a�
Ca rd. NO. ..` . . : ...:..:. .:
-S/.3�� ��o� �G� • o 0
COUNTYAUDROR
20 20
Couny
��s Ihis ded�w.4ion been requesled on poperty
.' wnent yeaR
❑ Yes ❑ No
20 _ 20 _
Dale (/rqrth. daY. Yea� _
I/ We certi y�under�aity of perju at e above and foregoing infortnation is true and cortetl and ttial Ihe applirants was / were a resident of
Indiana and owner e aforeme�tion roperty on March 1, 20
�reLU�e (—ow7ne/s I,A1 name) Dale (�°"/ / ���T —V �
��/T �i — _
Fsident address o�+dicant (fiwnber and s6eeL aty. stafe. arM ZIP wde)
(/" _
C " 1N �-1 O
Persan eulharaetl bY duy ezeated Paver of A[tamey w by IC G7.1-12-.07
Atldrrss of aulha¢ed pgsan (num6er arW s4eel, dty, sfate. aM LP code)
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