HomeMy WebLinkAboutMortgage_Stricklen.r °•* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
r4, ._ � FOR DEDUCTION FROM ASSESSED VALUATION ��
Sfate Fortn 43709 (RB / 2-07)
��'�,. � Prescribed by Departmenl of Local Govemment Finarxe
Fil
iNSraucnoNS: MAR 0 � 9
To 6e filed in person or by mail witA fhe CountyAuditor o/ the county where the property is locafed. �
Fding Dates: 1) Real Property: Dunng the 12 months be(ore June 77 0/ the year tbe deduc6on is fo be elfecGve.
2) Mobile Homes assessed under IC 6-7J-7: Belween January 15 and March 2 o7the year the deduclion is�g� eHec�i'9��
See reverse side /or addifional instnicfions and qualificafioru. O��a"�
�� DITOR
' Appl' nt ( wner or mnNacY uyeresge � ' on reve sde) •
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-'ng i fSe�yiumber I I al d _ O _ � � Record� by�r Page number
�c Y
'�. Assessetl value of 2al as of Marth 1, aarenl ymr Mwtgage / Coniracl indeWedness unpaid as of March 1, Is ihe appBpnl Ihe sda legal w equi�ade wmeR
�._ ) '�' ��� airtenlyear c� � ❑Y05 ❑ NO
y J
exaa
If name on record is
�
Name of mortgagee or coniracl seller �'
Adtlress ol mortgagee w mntracl seller (num6er and 1
Nartre of assignee w other orner or hdder of mortga4 �;
Address M assignee (numbu am/ sLeet city, stafe. ar.'j
Doas applicant own property in any other
counry in Indiana?
❑ Yes ❑ No
mmeone
_ - s'"i7
DI"�\\'C1' \ ...................
�I•c1 . ..................
...
S3 ,�2, avo. ° �
If yes, whet
spouse,
Is Ihe property in question:
❑ Real Property ❑ Mobile Hare (IC 61.1-7)
uestetl on properry
❑Yes ❑ No -
� COUNTYAUDROR
Deduction approved in lhe amount of:
20 O q_ 20 20 _ 2b 20 _ 20 _ 20 _
SynaWre of Counry Autlitor Counry Date (rtronfh, Eay, yeaQ
I I We certify under the penalry of perjury that Me above and fwegoing infortnabon is hve antl cortect and that the applirants was I were a resident of
Indiana and owner of Ue aforemenomed property on March 7, 20
re (owners /ull name) � � Dafe (mmth. day, yea�
�resi�add1 so ppli m(numberandsfreet.cif ete.ar�C�IPcoO� � � �^'
p l:ii `��� �i • (�
Person aulhonzed by duly executed Power of Ntrnnay w by IC 61.1-12-.07 Oate (rr�th, day, year)
Atltlress of aulhoirzed persm (numberand sveet, cRy. sfate. aM ZlP oode)