HomeMy WebLinkAboutMortgage_Tooley^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
. ' Stata Fortn d3709 (R11 / 6-09) � � � �
� � PresaiGetl by Department al Loral Govemmenl Frence
�w File Mark
STRUCTIONS:
b 6e lied in Y b N b P �1�1 �� �� �:
person w b mail with the Coun Auditor or Coun Rewrder o/ the coun wffi!s'�h� �p�ayi� located.
Fil� Dates: 1 Real Pro Must file durr Ne r/or whicA Ne deduction is so hG��"'�
ms 1 nem: � r� u� co�nrynuartor
2) Mo6de /ManuFactured Homes not assessed as Real Property Musf file during the_ hveZve�(12J months
before March 31 of each year the dedudion is mugAt. r. J.�` �� \ � Courrty Recordu
V V
See reverse side for addifional insUVClions antl qua/ficahons. ,,,TV e i ITOR
AooGrantlownerormitracfbuver-5eam�,Omsmreversevtlel i. GI J rv v �.
Keyfa�mber/legaldesaiption
[�-� -i -�o � �h Ga (-� d
As�sed vahie d real praprlty as of Matgage / Contran'videbtetl�ss unpaid as U Mortgage / ConttaC inCebteOrress unPaiE a d Is t�e aGG�t Me mle
Memh t� anent 1Rar MarU 7, arten� Year--7 �7 Eafe of aPG�� legal or eWitable owneR
�J'� / CJ�� ❑ Yes ❑ No
her exarl share oi intnest?
It IWIIC On �¢COftl 6 Qlfla
N3rtIC 0� rtqrt92gCC 0� c(
Aedress of mutgagce w
Name of assignee w oaa
(mmibe� and stree4 �RY, sb(e, aM ZIP mde)
Dces applitant w.n property in any oNer
munry in IrWiana?
❑ Yes
on approved'u� ihe a nt of:
20 _ 20 _
Sigronue N Ca�sN nadit«
I/ We rsgr�fy, under ihe penalry of
rtnrtgage
slate. antl ZIl
If y
I No
l
I 2(1
If owned xith someone oNer Can spouse,
�IS UIyC P��P�Y 111 QuE5LC11: MIIIIBaf ASSCSSCd
/ _ � RoPeKY ❑ Mnua�ly Pssessed
Modle Fbrt�e !IC 61.
I_
�� D' a�ti'ei• 1\'p q�Q� _�
�� Ca � � •
)UNTY AU'
1 �l l�ro
20 20
9��
`Ft � JC� ��, �/
that Ne above and (oregoing intortnation is We and cortecl arW thal Ne applirant is a resident of Indiana aM
�eA property on date apP��non is filed.
��.�o
o(AtlorneY or by IL 61.142-0]
Address of author'vEd Delson (num0ar arM sbee4 �Y, sbte. arM LP mtle)
Dafe (rtnnN. d2Y. 3'��)