HomeMy WebLinkAboutMortgage_Wright'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
� s FOR DEDUCTION FROM ASSESSED VALUATION �
• State Fartn a3709 (R71 / 6-09)
S T Presrnbed Ey �epartment a( laml Gavemmenl Frence
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INSTRUCT10N5:
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To 6e filed in person or by mail wi(h the CounryAudimr or Counry Remrder o/ the county where the pmperty is located. � 2 � � 0
Fiflng Dates: 1) Real Property Must file durirg Ne year for which Ute deducUon is sought. � Counry Auditw
2J Mo6Be / Manufactuied Homes rrot assessed as Real Property Must file dunng the fweNe (12J months ^�
before March 31 of each year the deduction is srought. 7rLJ Remrder
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See reverse side /or addtionaf instrucWns erid qualificatrons.
Ap m (ow�rorconvaC buye/J i � re/r ✓w"4iC e� , • r . [N .• •
Ta ��g O' � Key numEer! legal de5aip�ion ReWrE numbr! Page num6u
a -/b'- o-ooD� 5���-oa o9 I5�9
p�sess¢p vahre d� qoperty as d Mortgage / Contract'udehtetlnPSS unpaid az o( hbrtgage / Con� ude6ted�ss unpaiC az d Is Ne app6rant ihe sole
Merch 7. al�ent Y� MarM �1 jwrtenl ymar Eate of aPD�� k9a� w eW itade o.vneR
—I O O O ❑ Yes ❑ No
If rro, what a his / her e�ac[ shafe o( interest? If wmed wrth someo� other ihan spouse, udkate wkh wtrom
'H name m remd is diRerent Nan Nat ol app�ani, rtmdicate beb�r. Is ihe property in Quesbon: Mm�aOy Pssessetl
[�Real RoPerA' ❑ Mobi�� i.t-7)
Name of rtortgagee v mntrarl se9er
S.
Addtcss of rrortgagee w mntrsU se�er (mmber end sveet �y. te, arM ZIP code)
Name of assignee or other owner or hdder of rtqrt9a9e �_.--` '� �' � . i
AACress of assignee (num6erand street �: ��e, and Z/P cotle) �
Dralver!\'O. �(,Q
Oces applirvnt ovm property in anY oNer tl yes. what countyt What Ta�dn •••.......�, ., '
munbmin0ia�? , ••• o
❑ Yes ❑ No
Card7�'
COUNTYAUDROR i�O...... I...
��.......
DeduUion aprywed In Me amaunt of. O —
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20 20 20 20 20 _ _ ' _
Sigranne ol Counry Autlitor Couny Dale (monlh, day, Y�/)
I I e certify untl the penalry of pe Nat ihe above and foregoing infortnaUon is We and cortect arM Nat Me applit�n[ is a resideni of Indiana arM
owner I wntrad uyer of Ne afae Mioned property on date appfiption is filed.
� r��.,.,.,.t h�ll � Date (mwah. day. Y�A
�
FW � nt adtlress of a (num6er and streeG ary, sYdta, and ZIP aotle)
oi �.. � S+. + �.�, ir! y��46
IPgson auNOfrzcd Dy Gdy ezecu;ed Power of AttomeY � M IC G7.1-12-0.7 . Date (mon�h. deY, l'��
Address ot autho�'¢eG persm (number aM s�ee; cRy, stale. and ZIP catle) .