HomeMy WebLinkAboutMortgage_Weber (3)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__., � FOR DEDUCTION FROM ASSESSED VALUATION �
� State Fwm 43709 (R71 / 6-09)
�' u» � P25aibed M �epartmenl N LuW Govemmenl Fnfance
File Mark
INSTRUCTlONS: � E P
To 6e filed in person or by mail with the CounryAUditw or Counry Recorder o/ Ihe tounry whe2 the property is locat
FiNrg Dates: i) Real Property Must fi!e dunrg the year /or which the deduction is sought. �
2) Mo6ile / Manufactured Homes rrot assessed as Real Property: Must fiie dunng the tweNe (72) months [
6e/wa March 37 of eacA year the deduction is sought. � A
/
See 2verse side ta adtlitional insWUbns arM qualificafions. N COUNT
I!w iSownerormuracj6uyer�s erestrirbontmreversaside) .
� �,,, . 7J�� •
�oiption Remrtl numDer
-�oi-000. .33�-0 �. � aoo�
:/ Contract indebtedness unpaid as of Mortgage / Contract indebtedness unpaid as W
airtent year date of appGotion I
�� �Q �
s
tt name m remd is 6tfernn tlun that at appOrant, Indipte Debw:
Name of mortgagee or mntract seAer� � �
i
Pddres of mortgagee or mntracl se�er (n and sfree4 � �. and LP cade)
Name af assignee w oNrl owner or holder of mortgage
ACCress of asagnee (num6e� entl speet �: sfete, antl LP mde)
Oces applirvnt rnm p(operty in any oNer If yes, what county7
murur �� ��eana�
❑ Yes ❑ No
DedutAan apymN In Ihe amount of:
20 - � 20
Sg�drte d
20
If owned vri� somea�e oNer Ihan spouse. ildrcate wuh whom
COUNTYAUOROR
20
Counry Auditor
�aunry Remrder
�
❑ Yes ❑ No
yM�e{p�mpery. in auestion: Mmia�y Aswsud
X^��ProPerlY ❑!�n!u!a11YAa�5�
DI"a11'L't' 110...QlS,/i.J� ........
�ti.
' 3787 �
- Card 1\'Q: � ' .
- � : • �{,.$�: d' ....
_ �
2U_ i ___
Date (rtmlh. daY. Y��
I/ We certify unde�he penalty ot p�y that Ihe above and foregoing infortnation is Vue and cortect arM that the apptirant is a resident of Indiana a�xl
axner l contraIX buyer of Ne aforementioned property on date appiicalion is filed. �
(owne N me) � ' ��(/�+�.�Y.Y��
� Full en[ aENzss a t(number aM sLeet dly, state, ard ZIP mtla) 1 '
� .Sf �`i O
Person aWw�d Dy d executed Power of A[taney a IC G7.1 12-0.7 �(�N. �Y• Y��
Pdtlress of aNha'vcd person (number ard sbeet, tiy, sbfa, aM