HomeMy WebLinkAboutMortgage_Ramsey (2)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ _; FOR DEDUCTION FROM ASSESSED VALUATION
$late Form 43709 (R71 / fr09)
S � P2saibetl by �epanment ol Lnal Gwemment Fuiarxe
m.
ark
�lSTRUCT70NS:
o be filed in person o� by mail with the CountyAuditor or Counry Recorder of the county where the property is bceledcl 3 ��� �'
Filirg Dates: 1) Real P/operty: Must file during the year for which Ihe deduction is sought. fj��V � Counry Auditw
2J Mobile / Manufactured Homes not assessed as Real Property: Must frle dunng the hvelve (12) months
betore March 31 oleach year Ne deduction is sought. C.`�. Counry Recordu
See reverse side /or additional insWCfnons arM qualrfications. �
MW�� (owneroroontraebuyer-seeB�strir�'msM�revq�qside) GIBSON �. •
� � �J ✓�
TaAng �i�Ct � Key nwnber / legel de..rliption Remrtl numbv Paae numbrJ
� ���v�n � d
AsessM relue oF real p�operty as of Mwtgage/ Contract iMehtetlness un�
Matl� 1, amrnt year MamJ� t, wrtem year
//� ���
tt ro, what is his ! her erap share ot infelrst?
1f name m recoN n tlitle2nt than Nat ol aPpfipnt, 6Mkate bebvr
Name of rtrortgagee a cmtract seller l/�
J
Address of mortgagee n contracc se0er (nunbu and sfreel, cily, slare, aM ZIP codej
Name of azsgnee a othu owner or hdder of mongage
AEdmss ot assignee (numberaM avee; riry, stata, end LP cade)
Dces applimnt own property in any oNer If yes, what munt/i
county in Indiana?
❑ Yes ❑ No
COUNTY
Deruction appmved In Me amoun� af.
20 � 20 _ � 20 � 20
az
legal w equiNa6le amM
❑ Yes ❑ No
spouse. udicete Wth wMm
Is Ne ProPertY m Cuestion: MnuaMAssesud
��i a�o�ny p a4,u�y as�a
- $ I� —�131.��,15�
�i.a......
Dra��'er \0......
'� ;ted on P�RY
I � • • ves ❑ n
, .....
— r, _ _, �� .-. ... . . . . . •
L �l I �
\UI jS:.�; �
_ 20 20 _ 20 _
Counry I Data (mmtlr, daY• Y��
I/ We certify under Ne penalty of perjury that Ne above and foregoing infwmation is true and corteC arW that the applinnt is a resideni of Indiaria aM
owner I contrad buyer of the aforemerttbned property on date applicatlon is fiied.
Sig�atlue (ownels hN name) e� Date (monfi, daY�J. Wa��'"'�
i�✓NY+�a, � Ka1 n..114�� �'..% /—/�
�state, aM ZIP code)
A�K I�,
auNOrized Ey duty erzecuted Power o( Attomey or Cy IC E7.1-12-0.7 I Da[e (rtpnN, Oay, yea�
sotauthatreCper,a� (numbera�sbee;tdy,state,aMLPcotle) .