HomeMy WebLinkAboutMortgage_LacySTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
��.. . FOR DEDUCTION FROM ASSESSED VALUATION
SIa1e Form 43709 (R8/ 2-07) � f��
�' � PresviDed b�/ Department of Loral GoVemmenl Firiance T��
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Coun Tovmship Year
File Mark
INSTRUCTIONS:
To be (led in person or by mad with the CountyAuditor of the courrty where fhe property is located.
Fding Dates: 7) Real Property: During the 12 rtronths belole June 77 W the year the deduction is to be eJfective.
2J Mobiie Homes assessed'mder IC 6-7.7-7: Behveen January 75 end March 2 07 U,e year tAe deductia1 is to be elfec6ve.
See raverse side for additional ins6ucUons arrd qualifirations.
Dedudion appmved in �he amouni of:
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SigreWre af Camry Auditnr
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1/ We certify under the penally of perjury Mat the above and foregoing infortnation is true and corred and tliat tlie appGranfs was / were a resident o(
Indiana and owner of fhe aforementimed property on March 1, 20
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sfate,
erzeated Powa oF P.ttorney m by IC
of auihor¢ed persan (number arM stree4 �Y. slafe.
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Date (monN, day.