HomeMy WebLinkAboutMortgage_Wilson (9)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
, = FOR DEDUCTION FROM ASSESSED VALUATION
�• Slate Fortn 43709 (R71 / 609)
�• f Presaibed Ey �eP�^�nt of Lxal Govemmenl Firence
INSTRUCTIONS: �
Nad with:
To be fiied in person w 6y maii with [he CountyAUditor or Counry Recorder ol the county where the property is located. � �� u�U
Filirg Dates: 7) Real Property: Must file during fhe year (or which fha deducUon is sought. � County AuAitor
2) Mobile /Manufactured Homes not assessed as Real Property Must file danng the tweNe (72) months
bePore March 31 0! each year the deduclion is sought ❑ County Recorder
See reverse side /nr adtlitional i tmUaons and qualifications. �
nppGrent rorcqntract6uyer- reur�ct�ns�J rseside) WTV AIJDITOR
/i n•��i�! 1 A i i� S
�a �,e a re� wa�r � �
M2iCh 7, a+m1¢ ytar
If ro, what is his / �er esaU share of intefest?
,
_ � o . oov. a7a. 6a� ..�W.�.._...%� ..�_. ..._
�/ ConaaG iMebtedness unpaitl as of MoN3age / Con7aa ude6fedness �mpaiE as d Is Me app5�ant Me sole
airtem year date of ap V U legal or equitade ame!?
� �ip . ❑ Yes ❑ No
if ovmeC wiN wmeone oNer than spouse, hMkzte wIM whom
name on mmd a EMerent than Nat of appOpnt, inOicate bebrr
w� �r �� a
�� «�r,�a
w oNer owner or hdder of rtqrtgage
�, s
ACCress o1 assgnce (number aM stree; tlry, stete, and ZIP cotle)
Dces a�imnt axn pioperty in any oNer
counry m Ind'ana? � ..
Ci]
C
iM property in Guestim: MnuaM Asussetl
Y^— �oPerty �a,ouanya�essed
,o..�alp .,...
D,��„��r �
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� $3,�5(�•
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COUNTYAUDROR
wnt oF.
2p 20 20 20
Cwnry
r�
��D�Y
Yes ❑ Na
Date (rtqnlh, daY. Y��
%7�7
� I We certify under Ne penalry of perjury that the aDOVe and foregoing informalion is We and cortecl and that the applirant is a resident of Indiana arM
. owner / wntract buyer of the rementloned p rty on date application is filed.
� Sigrature (orrie/s /W reme) i / Date (rrrnth, day, ysa�
�
H /
/ FW resiEent adOress of a rcant (numCer arM s7reeS dN. �re. � Z�p �e) I
j .4/NU � t��. 7`'� Y�, z/✓ y 7�0 �f �'S
� Pason autM�rseE Gy Mdy executeO Power otAttomey or by IC 67.7-12-0.7 �. Date (rtanN, tlay, yea�
Pddress of auiha'¢ed perso� (number arM sfreet, tiry, stare, aM LP code)