HomeMy WebLinkAboutMortgage_Hopf"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
, FOR DEDUCTION FROM ASSESSED VALUATION
: . Sfate Farm 43709 (R71 / 609)
�' w. � Presai0ed Ey DeparVneN W Laal Govemmerit Frmnce ��
INSTRUCTIONS:
To 6e filed in person or by mad wiM the CountyAuditor or Counry Recwder of the munry where the property is bcated.
Filing Dates: 1) Real Property: Must file dun� the yrear /or which the deduction is sought. ' �,1f1��qqZ
2J Mo6de / Manufedumd Homes rat assessed as Real Property Must file dunng the hvervei�ru)Vrro4fhb�
before March 31 of each yeer Ne deduction is sotght.
See reverse side /or addiWnal instnxUons arM qvalifications.
Ap t(owr�¢r or contrarnY b�yer - see re' orts m le�erse stle) ) �/ J
. � (�L. q% ���Yi/M-�-[, Ph/ � �% T v/"fi� c�6soN CoUN7v
# rea� P�Y as
1�
� � CounryAuditnr
❑ Counry Recordu
-i4--�- ai-000, �o �_ o a� o i 353
h�rtq�ge / Contraa inde6tedn�s unpaid as d Mongage I Cantracl indebtedrress unpaid as ot Is Ifre appfrant Me sole
Memh 1 airtent Ye� tl2t8 of aGP�tbn kga� a eW rtade a�reR
I S D� ❑ Yes ❑ No
tt ownad wdh mmeone othrJ than spouse. fMicate wiTh whorn
tt twre m remd e?ilfemnt Nan Ihai of app6�nt, hkirate Debw.
Name of rt�wtga9ee a mntract se0er �
�
Address of nnrtgagce or contraq se0er (n
limht v.m property in any othu
InEiana?
❑ Yes
20
Sig�aMe W Camty aueitcr
rZ�7
1/ We certify u�der the penalry of
owoer I contract buyer oT the aFon
. (owneYs M1An�e) / /
No
stee4 u�: sta�.
�,P� �- P T
ur�.wn���mry.� w�,r���
20 I 20 I 20
Counry
Is Cre property N Oues9m: MnueOy Assetud
I�'Pa� Propenv ❑ ?nn!�II�! Asse��
513 g°„� .
�Qip ..........
D,�a,��er �o.... ... .
53�..�;....
Catd1O ,�Sa,9�• /
20 - � 20
Date (nanCi. day,
that the above aM foregoing intwmaUon is true and cortecl ard tha[ Me appiinnt is a resident of Indiana aM
�ed property on date apPliption is filed.
Date (rtmCt. daY. Y�/)
by IC 61.142-0]
Add25s of aWnrvEO Oersm (number artl sfreeG aN. SbM. en0 Z!P code) . I
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