HomeMy WebLinkAboutMortgage_Gardner (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_, + FOR DEDUCTION FROM ASSESSED VALUATION
• $tatB Fwm A3709 (R77 / fi09)
�• / Prrsrnbe0 hy �eP��M al Wral Goremmem Finanre
m.
INSTRUCTIONS:
To 6e filed in person w by mail with [he CountyAudito� or Counry Recorder o( the county whe2 fhe property is located.
FiNig Dates: 7) Real Pmparty: Must hle dunrg the year for which the deduclion is soughf. n
2) Mob�7e / Manulactured Homes not assessed as Real Property: Must file dunng the tweAre (12J monthS� E � 2
6efore Maich 31 of each year the deduction is saght.
See reverse side foradditional insWctla's and qualilrcafions. �yy�
AuCitnr
Recorder
,)[X��k j�f(,j� 01890NC6UNfiV AUnI?gP.
Ta ' �' ' Key numbel / legal dawipimn � Remrtl numbel Page wmbu
_ 9-19-( Q I-000• 1 c�''"a� b
AtsesseE value d real pmperty as d Mortgage / Crtaen�ytract'uWe6tedn�s unpaid as of Mortgage / Contract indebtetlness unpaid as d is Ihe eppilrent Ne sole
M3mh 1. nnvrt yPar Ma�ch 1, w / r� � llO ^ date of aPP�m� I� � YPS �P�
l� U ❑ No
If rw. whal is hts I her e�mU share Of interesi?
If name on recoN a E'itterent lhan Nat of appOrant, Nditate Eebw
Name at mMgagee n contract
mort�a9ee w mntraa se�er (numbe! errd s1ree4 �'jly, s�te. aiM ZIP ooda)
N assignee or aihei avmer ar hdder of tmrtgage
nddress ol ssUgnce (number and streeC ary. srete, arrd Zla code)
Does e�iont ovm ryoperty in airy oNer
�,�ry �� ib�a � ..
m
zo I zo
If wrt�ad wiN someme oNU ttun spouse. iMirate weh rAnm
couNn auc
zo _ � zo
ca,�y
Is the property in QuesDOn: MnuaM �
� Real Hoperry ❑ ArmuallyAssessed
�p�'dnQ�; � q., �, �,9"i �„ o�
�TeSS� Jr ❑ Na
Su�n ���'� , o.
513 � /s�, l��;
�� i _ i � _
oa� p,�wun. dar, y��
I I We certify urWer �he penalry ot perjury that the aDOVe arW foregoing infortnatlon is we and correct and that the applirant is a resident of Indiana and
ow'er./ contract buyer of Ne afo2mentioned,pmperty on date appiication is filed.
��amre (o� fidl reme) j� Date (rtmtb� daY. Y��
' �1
i d
11 " en address ot appfaant (number erW tlly; state, and ZIP mAe}-
� � �,5 � s�- o s � fi,� ,�,-«�� ��� ¢�6�F1
rson auNOrized Dy d�dy ezewte0 Power al AttorneY a M IC 61.7-12-0.� Date (monN. day, yEa�
Pdtlress of a W�oraed person (numeerarw uree4 dry, state, ana or coael . I �