HomeMy WebLinkAboutMortgage_Howard^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_, s FOR DEDUCTION FROM ASSESSED VALUATION
�. ._ • Stata Form 63709 (R71 / 609)
�4` P�ewibed by DeVartrtreM of LoW Gwemrtrent Fuance
STRUCTIONS:
To be lled in person w by maif with the CountyAuditor or County Recnrder of Ne county where the pmperty is locate� P R F
FD'ug Dates: 1) Real Property: Must file during the year for which the deduction is soughL Counry Audimr
2) Mo6de / Manufactured Homes not assessed at Real Property Must fiie dunrg the twelve (12) months � �un Recorder
6efo�e March 37 of each year the deduction is sought. �� h'
See reverse side lor addifional instruUeons arW quali�cations.
AppG�l (owner or convad byrer - see restriftions rn reverse sida)
7aring Disbict i(ey numbe. / kgal descriPtion Remrd numEer Page numba
a�-i8-i3-�o3 -000. 3 _ v a� d
Assessed vdlue d real Wopem/ az M Mortgage/ ContraG inde6tedness unPaiC as o( MMgage / Cantrul uWeMedness unpaid as d Is Ne ePP�^t Me sde
Ma�tl� 1. ament ymr Wafch 1, wrtent year date o( apP�m� �egal or cquitable amel!
9 QQ ❑ Yes ❑ No
It ra. wha�'s his ! hu e� sl�a'e of interest? If owneE with someorre other Ihan se. iMirate with wtrom
If fwrie m remA e ddferent �han that of aPpticant, 4dipte below. Is Me procenY in QuesOOn: MnuaM hssessed
� Real ProP?RY � �!!�Y � . . _
tmttatt se0er /� ^,
G���✓"'
or mntrad se�er (num6u and strneL uN. smte.
��er awner a hdder M mMqage
Aearess ot assig�ree (num0er aM s!
pp¢s spp�ipnt o�m ryoperty in any i
munry in Ind'ena? ❑ Yes
�
in Iha amoum oE
ano cir cooe�
ir y�. wnec
COUNTYAUDROR
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20 _ I 20 _ I 20 I 20 I 2(l — I �1— I 20 _
�tature U CamN AuOitw .__ I Caunry ( Date (�. daY• Y��
C -T •
I/ We cert'rfy under the Oenairy of {�rjury that [he �%ve arW foregoing infortnation is We and mrrect arW fhat the applinnt is a resident of iMiana a�
owner I contracl buyer of the aforemen � ned pro0erry on date application is filed.
,�animldw.�ls hN namel . // Date (mmfi, daY. Yaa�
Dy tlWy esetutetl Power
Pdtlren W
x by IC 61.1-12-0.7
stafe, and LP cade)
(monfi. daY Y��