HomeMy WebLinkAboutMortgage_Wilzbacher (2)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
._,. FOR DEDUCTION FROM ASSESSED VALUATION
StatB Form G3709 (R71 / 6-09) .
�' .«. .. Presaibed by Departmaril o( lnml Cawemment France
INSTRUCTIONS:
To be �led in person or 6y mail with the CounryAUditor or Counry Recorder o/ the county where the pioperty is 2
Fiiirg Dates: i) Real Property. Must file durirg the yrearlor which the deduclion is wught �
2) Mo6de / Manufactuied Homes not assessed as Real Properly: Must file during the fwelve (12) moriths
be(ore Ma�ch 31 a! each year Ne deduclion is sought. ,//
See ieverse side /or additionel inshuctbns arM qualificatrons. ✓� 1GG
qpprrant armntra�byer-seeresv'ramsmre�rrsevtle) GBSO COL
�°I�';` „ .r.... .. �. _ , �,.,. _ n _ 9'l i ) 'o _ o �
Key number / kgal desaiD� V Rewrtl numb�
;�� ;t(o - l4 - I 7-`��o _ o o/. 3 3 3-� a.� a O l t
d mal property es o( Mortaage / ContraC Iride6teCness unpaid as W Mortgage / ConYact mdebte0ness �mpai0 a d I
year Memh 7. a�rtem year aace a appu�atia, �
tl rwna m fBmd'a tliReRni N3n Ihat of aPpOpnl, hN¢
Nartre af n�rxtgag� or mnuau se�er
AEd�ess of nvt9agce or contratl se�u (number and sa
Name o1 assignee w other ovmer or hdder ot morigage
/�'7 �v s�
Dces epplifant ovm property in any othei
counry in Ind'e�u? �
❑ Yes
Deducuan app�wed in tlre amount oE
2� _ 20
9g�nneafCamrynWitor n
ti�� '
/�J
I I We certify unde e penalty of per
owner / contract buyer of the aforeme
Sig (a e/shNireme) �
���a G. I,l���
I I O Ient � � I( � ran
i�,
Pason autMfaeE cy dWy ezewted Pwer d
belov.'
ffi�,
stata, end LP code)
If yes, what munt�/±
No
somearie aher than spouse.
ROPertY ❑
County Auditor
counry Recorder
� y�7
ant the sde
ittade amen
Yes ❑ No
Mnue%PSSesseO
67.
� � J (! �
YMat Taritg D"str%f? Nas Nis de�#im Eeen rtQueStkd m P�W�Y
for aurent Y� r-� .. r-t .
GOUNTYAUDfi �
D1'a\vCt' NO... �� d......
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Caun�
� �yq,�zv,o� —
the above antl foregoing infortnalion i� � �� e� �u cwrea arm mat the appu�ant �s a resbent of InAiana aM
property on date application is filed.
by IC 61.142-0J
persan (number antl sbee4 �; sbte.
(��P
Date irtpnN,