HomeMy WebLinkAboutMortgage_Barton (2)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ N ; FOR DEDUCTION FROM ASSESSED VALUATION ��
Sfa[e Fortn C3709 (R71 / 6-09)
�' / Presvibed by Departmerd 01 Loral GovammeM Frexe
File Mark
1NSTRUCTIONS: �� O �
To 6e filed in person or by maii with the CountyAUditw or Counry Recorder o7 the counry where the pD� laat )�
FiNrg Dafes: 1) Real Pmperty: Must file dunrq the year for which the deduclion is sough[.
2J Mo6de / ManuFadured Homes rat assessed as Real Property Must h7e dunng the fwelve (12) months
before March 37 0/ each ysar Ne deduction rs sought. ����, �/(,y'�,
See reverse side fiu adtlitional ins6urJions a�M quelificatrons.
�
�������
i. ar�errt y�r
It iro. whaf b his I her exaa share of interest?
ro
If �wr�e m remtl a 6fferent than thai oi appOw�v, IMiote Eebw:
AdOtas d rt�ortga9� or wntraG seAer (numDer end straet uN. si
Name o1 assignee a oNer awnu or hdder W mortgage
Address ot assignee (number aM stree4 �Y. �te. aM Z/P ootle)
Does eppli�nt a«n property in any oNU If yns, wl�
county in IMiana?
❑ Yes ❑ No
DeEUCtion appioved in tice amount oE
20 20 20
CiIBSON
tlate o( appGption
///
Form Aed wiN:
� CountyAuditnr
❑ Counry Recorder
i i �i� i
Is Me epplrcant Ne sde
legal w equitade ovrtien
❑ Yes ❑ No
If avmetl with someone dher ihan spouse, Gdicate wIM whom
aM LP code)
COUNTYAUDROR
20 20
Caunry
Is Ne proprlty in Guestion: M^ua�Y AsseSUE
�al ProPenY ❑ M^�allY Pse�ed
Dra�ver i\`O. o! �?,/,tl..—
Card i\�O. ..../C � / .. No
.. ...•f.........
�
Date (rtanth. Cay, yea�
20
I I We certify untler Ne penalry of pe�ury Nat the above and toregoing infomullon is we and mrtect and that the applicant is a resident ot Indiana and
owner I contraci buyer of the aforemeMioned property on date appliptlon is filed.
�natlue (ownafsluDname) �) Date (rtmrti, day, yaar)
Pason auNa�d Oy
d
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andZlPOOtle)
or by IC 67.
peiswi (number aiM sbeeR dry. sb(e.