HomeMy WebLinkAboutMortgage_Fischer"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_�,. � FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R71 / 609)
�,�,� f Preunbetl M Departmertl al Laml Govemment Frence �
INSTRUCTIONS:
To 6e filed in person w by mail wiN the CountyAuditor or Counry Recorder o7 the county whe�e [he property is located.
Fitirg Dates: 1) Real Property: Must file dunrg the year lo/ which fha detluclion is sought.
2J Mo6de / Manulactured Homes rmt assessed as Real Property Must file dunng the (welve (12) months
before March 37 of each year the deduction is snught.
See reverse side /or additional instmcfions and quali�cafions.
ApyGOnt (owner ar,yrntracjQfprer - see rasMrtions m rerer;e side) _ 0 ,_ , n
Auditor
Remrder
� Key number / Rxortl numbe Page number
- -/�- 0.3-000 . 8�a -v a� �oo � �-q
I vdWe d real proprJty az W Mor(qage / Conbaa iMebtedness unpaid as of MoRgage / ContraG'uMeb[e0ne55 unpxid as ot Is Ne epp�mnt Me sde
¢rtmt ym Mamh 7.°��"� Year eate or avP�mtim legal w eWitade owne(.�
%,� /7n f% ❑Yes ❑ No
fs his / her erafl share of interesi?
tl name on feoDtd "s dtflerent Nan Nat of aDP���• �tlitate bebw
Name ortg geq or cono-arl seller
S,
Addres a1 rtnrt9a e w cantrad se0er (nurMr! and st
Name of azvgnee or other awner w hdder of mort9age
ciry, sta�. eM Z/P code)
(number aM atree4 tlry, slafe, arM Z/P wEe)
Ooes epplimn[ avn property in any other
munty m Intliana? f'l .,' _
If owned vriN someone ocher ihan spouse, iMicate with whom
I( yes. what muntyl I NTat Taan
COUNN AUDROR
ctlon appmveC vi Ne amoum or.
20 20 20
inrte o( CounN Auditq4
20 I cv
Counry
Is the praperty in question: Mnualty Pssesse0
❑ Real Properry ❑ Mnually 0.ssessed
Dra���er NO.::.°.�..O�.I,,,,,,
Card NO. ....-rJ..�.l.........
! � 1 � . lsl�
LU �
OatB (mon)h, daY Y��
I I We certf'urder the penalAi of perjury that the above and foregoing infwmalion is We and mrtect afM that Ne appfuant is a resident of Indana and
owner I mntraG buyer of the aforemen�oned property on date application is filed. '
Sip�awre�qwxh hN reme) /� � � Date P*�or+th. daY. Y��)
J( . . n .� . . Y " � , ,. ,. � .d�" � f . �i n � � 0 � l L—
by IC 61.1-12-0.7
Mdress of authar¢ed person (number antl stree4 �NY, sbte.
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