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HomeMy WebLinkAboutMortgage_Ivy.+°•^ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n T h Year x,, ., � FOR DEDUCTION FROM ASSESSED VALUATION Stale Form 43709 (RH / 2-07) �°�;:,� j Presvibed by Deparlment of Local Govemment Finance File Ma INSTRUCTIONS: To be filed in person orbymail w8h fhe CountyAuditor o/the county where the propertyis located. � `-yr �� F�7ing Daies: 1J Real Property: During the 72 months be/we June 11 0/ the year the deducUon is to be eflective. O'/ 2) Mobile Homes assessed under IC 6-7.7-7: Behveen January 15 end March 2 0/ the year the deduc6�istn �� � qUDITOR See reverse side lor addi6onal insWctions arnd qualifications. 8S V w mnVadJ]uyer - see � Ta�drg DisVi Key number I leg�desaiption Remid num r Pege number d-. �- -l3-l0/-oo/•�a - ��6 0� 7� Assessed value of mal popaty az d Mart�h 1, curenl year MMgage I Caniracl indebtedness unpaid as of March 1. Is Ihe apptipn� Ihe sole legal a eqtritahle wmeR artent year � � Q Q C� ❑ Yes ❑ No "�o, wtiai is his I lier enacl share of interesl? If owned with mmeone dher lhan spouse, irdicate wilh whom. �i name on recora Is afierant lhan inat ot applirant, Indimte belav: Name of morigagee ar mnUact seller S,�__ Addrass of rtwrtgagce w mnlracl seiler (number and SGeet, tity, stafe, aM ZIP rode) Name of assgrice a other oxner w holder of morigage Address ot assignee (n�mber erM sfreel. dty. �ate. and 21P code) Does applicant am property in any other II yes, whet couny7 courriy in Indiana? ❑Yes ❑ No COUN Deduction apD�'� � the amount of: 20 � ZO _ 20 _ 2� _ � � SignaWreofCounyAUtlibr n � I/ We certi�,Gnder the penalty of Indiana ar�Y�ovmer oi the afwemE S� nmi�.a r... � �,, _ __ � 4 �mvdent adtl of applicant Snv� —702 /<o,�.�Pu'� i Is �he property in question: ❑ RPaI Pmperty O Mobile Home QC G7. What Ta<ing Dis' ' . I Has Uio deduaion baen requmted on praparty fw arrenl yeal7 � _� ❑ Yes ❑ No �UDROR ����//�L� _ SG� j � � — � D�_ ����` � - CouMy e-� that the above and foregoing infwmafion is We and corred and thal fhe apy.. property on March t. 20 anafuncL cd1y. sfa%f%e. arM Z!P m/ 'r. i�/� C)�a��/i � of Ntomey a by IC 61.1-72-.07 PAOress of eulhoraed person (number aM street, aty. stefe, yaen daY. Y�� ent of