HomeMy WebLinkAboutMortgage_Whitten'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
.__ ,• FOR DEDUCTION FROM ASSESSED VALUATION
• . � State Form 43709 (Rit / 6-09) ��
S�.�. ? Presaibetl by DeP�nt of Local Govemment Firence �
File Mark
�wsrRUCnoNS:
To be filed in person or by mail with !he CountyAUditor or Counry Recorder o( tAe county where the proP� p locat�.11 F� �� �m�
Fitirg Dates: 1) Real Properry: Must file dunng the year for wfiich fhe deduction is soughL Dt� �� � Coun Auditor
2� Mobde / ManuFactu2d Homes rrot assessed as Real Property: Musf file dunng the fweNe (72J mon ry
before Ma�ch 37 0( each year the deduction is sought C 7 n� ❑ Counry Recorder
See reverse side (or additional insVUCdons
'. PypGrant (owner or contra uyer - sre re.vri^tj
GIgSON
Ia iy thstrrl — I Key number / legal desmption Remid number Page numErl
�g- i 3oo-oc,�-aa�-oas aon s'te
Ass�sed vdNe d real Woany as Mortgage / Conbact'vMe6tetlness unpaid as of Mortgyge I Contract'uMebtetlriess unpaid as a( Is Me ap�t Me sole
Marrh 1, dnmc year March 7. arte 1 r Oate o( applimtian legal d equitade oxnell
1��d�� ❑Yes ❑No
I( rw, what a ha / her e�c1 share of interest? �pi �¢o� �¢� ��
spou5e. ind%ate wiih whom
Ii name m mcvN is Srtferent lhan Ihat o( apptican4 �dicate 6ebvr in QuesUm: MnuaAy /uessed
� PeKY ❑ �uaPjA55e55ed
�� o, ��� a
Address of rt�ortgagee or mntraG seDer (numbei aM sneef, dry, sfafe,
Name ot assignee or other owner ar hdder of rtwrtgage
Adtlress of as4gnee (number and stree4 dry, state, antl ZIP ootle)
Lbes appfinnt ovm property in any other If yes, what
munry in IMiana? � �
aOtl
- �c��l CoU
1 `�-+ 1�.�.11L/
i � eauaion Oeen req�estea a, a�m
t yeaY.+ ❑ Yes ❑ No
COUNTYAUDROR
Deducfirn approved in Me amoun[ of:
20 20 20 20 _ 20 20 20 _
SignaN2 of Counry Auditw Counry Date (mwrth, tlay, yea�
I/ We certify under the penalry of perjury that the a6ove and foregoing infortnatirn is We and mrtect and ihat the applipnt is a resident of Indiana arW
r/ conVact buyer of the aforementioned property on date applicatlon is filed.
S' (owne/s hAI name) Date (rtmfh, Cay, y+ea
(
,ull resitlent dres of appli nt (number antl stmef, rity, state, aM Z/P cotle)
7C% I O �. �
f I
Person autlronzed Gy tluty executed Power of Attorney m by IC Gl. t-72-0.7 Date (monN. day. yaa�
AECress o( author'vEd person (num6er aM sneet. ciry. state. and Z!P code)