HomeMy WebLinkAboutMortgage_Harder (2)"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ .� FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R71 / 6-09)
�' ,�,� � Presuibetl by �epartmeM of Lacal Govemrtrent Frence
File Mark
�vsrRUCnoNS:
To be filed in person w by maii wifh the CountyAuditor or Counry Rewrder of the county where the property is located. F d'�h:
Fiiing Dates: 1 J Real Property Must file during the year for which the dedvUion is sought. C� Auditor
2) Mobde / Manufadumd Hortres not assessed as Real Property Musf file durirrg the hvelve (72) months
6efora March 31 o/eacA year the deduction is mught �0�, ef
See reverse side foraddi(ionel insVUCtions and qualifications. GIB U I
D' ' Key ber / acsaiG � � ' �,/{ O. � � ^ — � Recrnd number P umjwl �
<JCl p 3 c�
� veNe d real PoO�Y as o( Mwtgage / Cmtraa indrbtedrress unPaid as d Mortgage / ConbaC'vdeMcdness unC� az d Is Ne aPP�� Ne sde
t. aarenf smr Marm 7. wrrent rear aare af aPP�tion /� ��,/� �gal ar e�de avmerr
��CJ. �! A J ❑ Yes ❑ No
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IId1I12IX1
Nartre ot mort9a9ee or convaa sHler
YIQIqiC bC�OW.
Address of morc9a9rx or mnbaa seUer (number and street,
Name of assipiee or oNer owner or
SOf11E01fE
:5 pfOp2llYiI1QUC5bOf1:/VIfW2�ilSSCSSEd
Real Property ❑ Armually AssesSed
Mobile Hane (IC 61.
AACmsS of auignee (numbBraM S1RE4 �y. slate, antl [IY cotle)
�Lv a� - /o � . /�.
Dces applinm orm ryoperty in any oNer If yes, what munt7/t Wl�at 7a�d(g �alria? Has �his deEUUion 6een requested on property
tounry in IMiana? ❑ Yes ❑ No (or curtent YeaR ❑ Yes ❑
Ded�Mion aPWoved'vi tlre amount oF.
�— � �—
sig�nne d cau,H auenor
20 � 20 � 20 _ � 20 � 20 _
I I We certify under Ue penalry of perjury Nat Ne above and (oregoing in
owner.l con act buyer of ihe aforementioned propeRy on date appiicado
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FW � nt aCAress of a t(number antl sfinet, dty, sfate. and ZIP mtle)
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Pem,on auUnraN Dy OWy ezeaited PorerW AttomeY w bY IC G7.1-12-0.7
of authw'ved person (numbar aM stree4 c/ty. sbte. and
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�) 4�� O� T nt of Indiana antl
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