HomeMy WebLinkAboutMortgage_Hillard (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__,. � FOR DEDUCTION FROM ASSESSED VALUATION
� . :• Stata Form d3709 (R71 / 6-09)
S,�,. f PresaiEed by DepartmeM of LnW GovernmeH France
de Mark
INSTRUCTIONS: ,�1I�^
To be filed in person w by mail wifh the CountyAuditw or Counry Recorder o( Ihe county where the pioperty is Iw�CW 0 ��
Fifiny Dates: 7) Real Pmperty: Must fde during the year fir which the deduction is sought � Counry Auditor
2) Mo6de /Manulactured Homes not assessed as Real Properry: Musf fi!e dunng the (weHe (72J months
before March 31 of each yeer the deducfion is sought `-y�7� Counry Recader
p�r
See reverse side (oradditbonal instruclions and quali�catrons. UDITOR
�,. AppGrant (owxr or mitrarY byj'r�ee restrcfions m leverse •T, � � •/� A
Oistrm� Ke
� -
ee .aAc � mat a�r as a
I, prrent year
If ro.
na�rie on
NOipte Oelovr.
Name of morigagee or mno-ap u4er �
Addr� W nxMgagee or contrad sWer (number end st
Name of assignee w ahu ovmer or halde� M nwrtgage
PdCress ot asticgiee (numDer entl stree; ray, slete. arc
Does ePplifant own yoperty in any oNer
munry in Indiana? ❑ Y25
❑ No
Deauc�on app�wed In the amoum af:
20 20 _
Sig�Me d CnmN Autlitor
I I We certify und r Ne penalry of pe� ry that
owner I mnt�uyer of the aj6rem�ition
83a-oa,s ��
unpaid as U Morigage I Con;re�Y "vmde6tedness unpaiE
date a( appGcation
It owned wiN sommne oNer Ihan spoum. ind'zate with whnn
3pplivnt @re sok
r equitaNe awneR
❑ Yes ❑ No
Is the propem/ in Questim: MnuaM AssesseE
❑ Real P(oPeNY � ��a��Y ���
Modle Hame (IC 61.
u. . Dra�ver �iO ,�°/�/� 4 _-'— - .is deduclim Eeen reQUesled m O�Y
�� re 9 .rent yeaY.+
�'1W.,.L...... ❑ Yes ❑ No
= Card �ip y� •.
- ��fia, 9 �S �, ....... ..
� 20— � �— �
�� (�.
the above and foregoing infortnalion is We and cortect and ihat Ne applipnt is a resident o( Indiana and
n date applicatlon is filed.
/ i Data (monfh. daY• Yae�)
or bv IC 6t.f-12-0.7
person (numbe� and sbee; rity, state, an0 LP wtle)
�Y. Y��)