HomeMy WebLinkAboutMortgage_Kiesel (9).�* ""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
S1ate Fortn 43709 (R8 / 2-07)
�' ,�,� � Presrnbed by Departmenl of Laal Govemment Firiance
File Mark
INSTRUCTIONS:
To be filed in person or by mad with the CountyAuditor of the county whe2 the property is located. � �f L 2 5 2 Q Q$
Fding Dates: 1) Real Property: Dunng the 12 monfhs befwe June 17 of the year the deduttion is to be eRective.
2J Mobi(e Hanes assessed under IC 6-7.1-7: Between January 15 and March 2 0/ fhe year the deduction is fo be elfective.
See reverse side fa addifional ins6uclions and qual�cations. � �� ,Q�
Applicant(a�yn n7atYWryer-see reversesde) / _ �_ n
T' isUid Key nu / I al �aiption = ' � '��� Remrd nupyper� Page rp�mbe���
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Assessed ralue af real propeM1y az af Marth 1. anenl yrar Mwtgage�Cul � i' eO nes� id as o/ March 1. Is �he appGnnt Ihe sda lega� ❑ Yesde❑ No
airrerri �
al is his I her ezacl share o/f 7in�teresl7
onr d�sdAf �Iha�lh'M�aOd
If owned wi�h wmeone other Ihan spouse,
Name of marlgagee or conVact seller
_ ___ -- --^--�
Address of mo�gagee w conlrad / (�� / ^J .
9 �i�ci��'ei� �TOaVoU �l /��
Name of assi nee a Wher oNner ' �,
Address of asvgrree (mimber aiH
CaCdNO . .....................
Does applicant own poperty in am /� /1 //,
counry in India�? � Y85 � D/�% (J /(/ /� v✓ O� a U
COUNTYAUDROR
approved in Ihe amoun� of:
20 U� I 20 - I x1 I 20 I 20
Is Ihe property in question:
❑ Real Pmperty ❑ Mobile Home
'1 • -�0�- 3�1.
Has �ha deduGirn been reques�ed on pmperty
1ar wRen� yeaR
❑ Yes ❑ No
2p � 20
�e a( N Auditor I__' 1/ I Cw�ry I��`! r tl�y""�� ��
V
I! We ce� under penalty of perju al ihe above and foregoing infortnation is We and mRed and ihat tl�e applinnts was / were a residenl of
Indiana and owner o the afwementioned property on March 7, 20
i„awre �� s MI name) Dale (nanN. EaY• Y��)n
0 ( /i _ � i -G��Od�
�
��,�d (a�ddnr of applicar/it '(nvmber and sGeet city, siate. and LP cotle)
7 d� S S 7J�^/" FL /Qf4nGI, �/ y�� y�' .
rson authrnaetl bY duy ezeated Power oflLLlaneY a by IC 61.1-12-.07 Oate (month. Oay, yea�
Address of aulhor¢ed persm (num6er aM streel, cEy, sWte, arM LP
1-7)