HomeMy WebLinkAboutMortgage_Miller (6)"•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ � FOR DEDUCTION FROM ASSESSED VALUATION
• Sta[e Fartn 43709 (R11/6-09)
� � Presaibe0 by �epartmeN of Lo�l GovemrtrerLL Finarxx
File Mark
INSTRUCTIONS: ������-----��� g
To be filed in person a by mail wifh the CounryAutlitor or Counry Recorder o/ the oounry where the property is ��
Filirg Dafes: 7) Real Property: Musl file durirg the year for which Ne deduction is sought. � q� �
2) Mobile / Manufecturcd Homes rwt assessed as Real Ploperty Must file dunng the tweNe (12) ths
befwe March 31 oI each yenr the deduction is sayht. ecorder
See reverse side 7or addftional instrvUions and qualifications. � E . 9 7 � �Q
App&-dni(oHlierorconyqrl6N'e�-see�stri�'pnpa^relT�?�l � �l "., .
f vaWe ot real o�r ��
amnt year
It ro.
nalrie on
ma share of i
feRnt than tha
conttactse4er
�6 � a�,� - I U�' ll.:-fiJ. Y� T e�- �o� 1° GIRAn f�v e
ge / Contraa "uwebteeness unpaid az ot Mortgage / Con� i`We6tedness �mpaid az d Ls Ne
Ma t. a�rtent year date of appGration legal �
Address of mortgagee or wntract se0er (numbu and sveel �};
Name af assi9nee w oNei wmer or h
Address ot assignee (number aM snc
Dces ePdifanl am p(operty in any ot
munry in InEe�? ❑ Yes
Dr�uctlon app�oved In the amount of.
tlry, stete,
Na
yes. whal munty7
zo � zo— � zo—
ot Counry Autlimr
I I We certify under the penalty of perjury that Ne above and foreg
owner I mntract buyer of �he afwementloned property on date ap�
bytlWy
person (number aM snee4 �N. ��. antl LP cotle)
WhaiTa�drg Districc?
COUNTY AIIDROR
ie poperty in Question: Mnu�
Real Property ❑ Mnual
• hbble
7
iRade owneYl
Yes ❑ No
s ihis deducTion 6een requested on p�nperty
cu(rent yeaR � Yes ❑
llra��•er \'O. �G��........
c^^1_�-�a_ -�L�o`.' �...._5M�a � .....
�4� `v � " `"`X
X
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�
�.�r.r�d
� resident ot Indiana arM
i. daY.1'ea�
Date (monfh. daY. Y��