HomeMy WebLinkAboutMortgage_Elpers^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
__ s FOR DEDUCTION FROM ASSESSED VALUATION
� $tate Form 0.3709 (R11 / fi09)
� PresaibeC by Oepanmertl of Loral Govemme�ri Ftrunce
NSTRUCTIONS:
To 6e filed in person w by mail with the CountyAuditor or Counry Recorder of the counry where the property is located.
Filirg Dates: 1) Real Property: Must fi!e dunrn� Me year Por which the deducUon is sough(.
2) Mobde /Manulactured Homes not assessed as Real Property: Must file dunng the N+eHe (12J months
6efae March 31 of each year the deduction is saqht.
See reverse side for additional instrucUons and qualifica6ons.
Aod'�nt(ownerorcontractbuve�-seeresbir�ouou�aversesidel "/
�.
couNrr
��/ Auditor
Ta�dfg Dis � . Key rnanber / legal dewipEan � ' • Recoid num6er Page mm0a
a�o -� ! �� - oi -000. �°P�.>o�� ao�� � �
ns�ed vak,e of real popemi � o� Mortgage � co�o-aa ineebtea�sa unpaid az ot nrortyaqe � cono-a�x uMeetedness unpaiO as m Ls me appf�n, me sde
Mamh 1, nmvn year March 1.artent yeer dat af applifat/ion kgal w epuitable owneR
�Qp� JQ� ❑ Yes ❑ No
If ro. what ¢ his / her exact share of interest? If owned riM someo� otheJ Ihan spouse. iMirate wM wMm
name on
Name of rtmrtgagee u mno-aU seller �
Mdress o( nartga9ee a mntrar] sWer (n�mLrJ and stree4 �; state. aM ZIP cotle)
name o� assgnea w omer owner ar rwwer a� rt�orcgage
nearess
counry in Intliana?
� and so-eet �1: �
in oUer
� Yes ❑ No
D�uction apprwed in ihe amount of:
20 � 20 � 20
Sigranne w ry nwitor
-T ��
I/ We certify umler ihe penalry of
owner / conVaU buyer of Ne afon
sLeet.
Ur, a � � �/
whatmunt�? What7aprgD'u
COUNTYAUDROR
_ 20 20
Counry
�e property in question: MnuaDy AsusuV
Rea� aroaertv ❑ ,4rmualy assessea
Madle Hane (IC 6
o���„-�,�.'O.. �2Dla.
Card NO. .....�5?..........
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zo
!o
the a e and (wegoing infortnalion is We and cortect aM that the appiirant is a resident o( IMiana arM
prop on date applinlion is filed.
Date (monfh. day, Yaa�
Date (rrronfh. tlaY, lsar)
Address of auMd¢Ed person (number aiM street. ary. sbfe, and ZIP code)