HomeMy WebLinkAboutMortgage_Holmes"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
FOR DEDUCTION FROM ASSESSED VALUATION
Sta[a Form 03709 (R71 / 6-09)
�' ,w � Prestnhetl by Oepartrtrent ol Laal Govemment F�nce
wsraucnoNS: �
To be filed in person a by mail with the CountyAUdito� or Counry Recorder o/ Ne wunty where the prope�t�l.
Fiiirg Dates: 7) Real Property: Must fJe during the year for which the deduction is soughG �L
2) Mobde /Manufactured Homes rrot assessed as Real Property Must fiie dunrg the tweHe (72) montAs �
before March 37 0l eacA year the deduclion rs sought SEP
See reverse side 7or addiLOnal inst/uctlons and qualrfications. �
Tab�g Di rw
��m� �
w�m�,eare��,�w
A13�U 1, tlx�art ye2r
,
�1 ia. what Is h"x I her exaa share ot intemst?
Name oi mwtgagee «mno-aU selle
ndaress w rtnrtqagce w conaaa sc
Narne a1 azsy�ee or omg ow�e� «
Atltlres5 0( a55ignee (numDer and 5treef, rity. 5fate, end ZIP mEe)
Dces applifant own pmperty in afry other If yes, wh[
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Mp�pyge � cono-aa vx
Mamh 1. artent ye�r
owwicare oe�ow:
and streeS �y. state, ard ZIP ooda)
app�oved in ihe amount oE
/�,o7-O
If axned wiM
Recorder
Pape numGer
ves u No
is Ne P�OertY in Ouestion: MnuaM Assessed
�alProperty ❑lvmuallyAssessed
Rbdle F�bme (IC 61.
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d m pmprJty
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COUNTY Ao.... _.
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Sigfuture of Counry Auditor Caunry Date (month, OaY Y��
I/ We certify under ihe penalry of perjury that Ne above and foregoing infortnaGOn is We and cortecl and ihat the applinnt i5 a resident of Indiana arW
owner I contract buver ot the aforementioned property on date apDlicadon is filed.
ss of appficank'(numb7e�rantl street stare,�`'� LP m
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oy aWr ��;ea vwRr o� w�,er w M ic si.�-��
sd person (numDer arrd stree; dry, sfate, and LP cotle)
oa�e (mo�w. aar, r��
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