HomeMy WebLinkAboutMortgage_Wilkerson (17)'�* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
SWe Fartn 43709 (R8/ 2-07) .
�° � Presvibe0 by Depertmenl af Local Go�emmerrt Finance
��M
iNSraucnoNS:
To be filed in person or by mad with the CourrtyAuditor o/ tlie county where the properfy is located.
Fding Dates: 1 J Real Roperly: During the 12 monMs be/ae June 11 0/ the year the deduc8on is to be elfeclive.
2) Mobile Hames assessed toider IC G7.1-7: Belween January 15 and March 2 0/ Me yeer fhe deductim is fo 4eMSectiver. 2009
Sae reverse side lor edditiorel insWctions a� qualifications. H � t( 1 O
Q
T�� �� K� ��, a6 ' i� -i3-�� -oao..�s -o a6 �W,�� ... . r�� 1
qssessed rdue of real popaty as d Marrh 1, nrrerM1 ymr Mwtgage / Contraq inde6teCness unpatl as of Maich 1. Is ihe appGwnt Ure sde legal a equitahie owne(1
a`�"'�` �fS00 �
❑ Yes ❑ No
It �^ �s his / tar e.m�Y share oi 4uerest7 If owned wdh sortieme ather tlwi spouse. indicala with whom.
If� recard is Eif(metd Nan thet ot applicaM, i�mte belo+r. Is Ihe prapaRy in quastim:
❑ Real Pfoperty ❑ Modle Home QC Gt.
Name of mortgagea or ar�Vaci seller ����
Address of morigagee or caniract saller (number arM street G1Y. s6fe. arM LP code)
Nartre af assignee ar dher owner a
I�:�
Deduction
own property in eiry dher
m�
❑Yes ❑No
of:
city, sfafe. aM LP mde)
u yas, �,a�
20 �`% � 2b _ I 20
� g1
i 0���� /�
>UNTY/ � G li�
� p0
p I � � -�
�,�o��
❑Yes ❑No
20
County CouM' Oale (rtmlh. daY. Y�/�l
— W �
I/ certi er of perjury that ihe above and fomgoing infortnation is true and mrtect and Giat Uie appGnnfs was! were a resident of
Indiana an er of fhe ementimed property on March 1, 20
� a r„u,�«r� nn.,a..�e� .� .. Date (month, daY. Y��)
sfafe,
Parier dllbrneY a M
nadressoreNnaaeaper.,a, (nummbe.a�dstreet,cry.srsre.e�duPwae)