HomeMy WebLinkAboutMortgage_McCarty"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_,_ , FOR DEDUCTION FROM ASSESSED VALUATION
State Fofm d37Q9 (R71 / 6-09)
� y,� � Presa�3etl M DePamneM o( Lod Govemment Fi�rce '
H
INS7RUCT10NS:
b be filed in person a by mail wiM the CounryAuditw w Counry Recorder of the wunty where the property is located.
FiRng Dates: 1) Real Property: Must file dunng the year for which the deduction is wught.
2) Mo6Be /Manufactured Homes rwt assessed as Real Property: Must file dunng the tweNe (72) months
6efora March 37 of each year the deduction rs saqht.
See re ers side for additional instiucGons and qualifications. r, • ,
of interest?
-000•s4a-f�26
H nama m iemtd'a L'ifterent than ihat of aDO�^t intlirate Gelrnr.
Name W rtnrtga9ee ar mntract se0er /
..%
Pddress of mon9aa� w mnbaG se�er (nunDer end sbaet �Y. ste�. aM
m zssi9nea «ahu avn,« or
Ii�an[ own yoperty in any aher
Intleria7 ❑ Yes
DeduCion approved in tlie amoum
ri'�
Sig�atlxe U Ca�mb AuOitor
rroigaga
rdy, State. and
�� ri
20 - � 20
Counry Auditnr
unDaiE as of Is Ne applkant Ihe sde
kgal or e0uilade avmeR
❑ Yes ❑ No
If owned wiC� someone atha �han sPOUSe. mdicete wiM wlwm
Drawcr \'0�..°.��.�.......
Card NO. . °�.�.(°..:�.......
S/� iV�� O�
Is Me property in puesDm: Mnu2M Pssesse0
❑ Rea� Rovem� ❑ !+!�!�!�M �
� �� a�
. wrron rean
�
�«��
Yes ❑ No
Date (rtqmh, daY. Y��)
20 _
I/ We certiry undef Ue penatty of perjury that the above aM foregaing intormation is true and cortect arid that the applicant is a resident ot Indiara antl
owner ! contract buyer ot ihe afaementioned property on date applintion is filed.
inaoae fowirers futl na 1_i . / �� (�. daY. Y��
M
w by IC 61.142-07
prlson (numbereM s�eeL �: sbfe. an0 LPCOde)
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