HomeMy WebLinkAboutMortgage_Ingler"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun �qwnshi
_,_ _ FOR DEDUCTION FROM ASSESSED VALUATION �.
• State Fortn 43709 (R71 / 609)
�' u�. 1 Presaibe0 M�rtmerit o1 Lnrai GbvemmeM Fkiance
File Mark
INSTRUCTIONS: r � �
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To be fiied in person w by mail wi(h the CountyAUditor or Counfy RemNer ot the tounty whe2 the properry is located. �
Fi6rg Dates: i) Real Property Musf !le dunng the year (or whirh the deduclion is mught. Counry�����yuuueitor
2J Mobde /Manufactured Homes rat assessed as Real PropeRy Must fik during the twelve (12) monfhs 2�,. ,G�
6ehle March 37 0/ each year Ne deduction is so'ghG `���
Seereversesidelofaddifbonalinstructlonsandqualifications. GIB .,�..,...,� ., � .
AppGCant(ovw�r oontrarJbtryer-see rsesi]e) �
a
istri Key / 1e9a1 Remid nu P e
- - - a - n D . 3s'1-ba �
As�ed �ahre d rral propaty az oi Mortpage I Cantract "videbtetlness unpaid as ot Mortgaga / Contract inOebieOness unpaiC as d Is Ihe apd�� Na sde
MaN� 1, arrent year Marc�'7,�.v�t ye�� date of appGrat�on legal or equrtaWe owneY7
I '°�'�ii ili7TT— Cl Yes ❑ No
�f�.����,���o,���, 3y,o�
If name onleNtd "q ddferent Nan that o( aDpOCant, cidirate Gebw.
oi mort�agee or mntract seqer
w mntrad sr�er (nun6eiard sbce4 �: stale.
someone oNer than spouse.
AdCressotassgnce(numberaMStree4�M1^_'____"'__ ____ '
DcesapplimntownyopeM1yinanyoNer DI"al\i�er N�. ��
��������? � ...........q: -:.
❑ Yes
Deduction appmved in Ure amoun
1 2� _ 2(1
�
�
SyraLne N Camb Auditor
Card NO. ....�'�`�......
� 3ti,`�3u. o�
Couny
Is me woPPm fo aue�a,: n��ua0y Assessed
❑ Real Roperly ❑ Armually Assessed
Mobile Fb�tie (IC 61.
Has N's dedw]im been re0ue5teO an P�Y
For arrent yea!? ❑ ves ❑ �
20
L•.:t�T
TO
I I We cert'rfy under the penalty o( pe�ury Nal the above and foregoing informalion is We and correct arW that the applit-ant is a resident of Indiana a�
owner I mnha�3 buyer oi the atorementioned properry on date appl"rcalion is fited.
�pab�re (owneh hA reme Dale (nrntti. daY. Y�a�)
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(numDerantlsbeet
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persan (number and sbee; firy, stafe, a/W
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