HomeMy WebLinkAboutMortgage_Cavett'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coum
__ , FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fartn d3709IR11 / 6-09)
1�.�. Presaibed Ey DePM�� of Lod GovemmeN Fi�nce -
INSTRUCTIONS:
b Ge h7ed in person w by mail with the CounryAUditor or Counry Recorder o/ the co�nty where the piopeM is bcated-
FiNrg Dafes: 7) Real Pmperty: Must fde dunrg the yrear for which Ihe deducfion is sought.
2) Mob�le /ManWactuled Homes rwt assessed as Real Properry: Must file dunng the hveHe (72) monMs
6efore March 31 of each year Ne deduction is sought.
See reverse side lo�adAifional inshuctions and puallficateons. � \/1 n
-I 1-VbO�D �
/ C�Qact irdebtedness unpaid as of
If Iq. whal ta his / he! exaC shara Of interest?
tl fwrre nn ramd's 6ttplent Nan Nat af appl
nprtgaga or mntract seder (ru�^• --• ---raY. smte. arq LP mde)
Dra���ci• NOa�.°.�.6.:. �•'•�.�.
Card\O . .....................
DeducGan appoved in ihe amount of:
20 20
ttnr
I/ We ce urWer tha nalry of perjury th
owner I mnhact buyer f e a(oremention prope
Siananue (o�x�el9 !� rertre)
couNn nuorrort
20 20
Counry
the above aM foregoing in(ortnaGOn i:
rty on date apD���n is filed.
F ��t em�ess w avMuant (numeerane sLeet N, srate, and z�a coda)
�189/ 1,,� 1255 �.��+�� sN
Peison autf�waed Oy Euty ezecuted Power of AttorneY a M IC 67. -12-0.7
Address ot aWio�'ved persai (numDer a�M sbeat ary. smfe. an0 LP oode)
File
�r' �'iJ
�ry Auditnr
Counry Recorder
o(aP� I �
sortwone other Ihan sPW�. uMkate with winm
IS C1C P�G�Y Ifl GUtS}I[lll: M
❑ Real Rope�ty ❑ Amu
DistrvY?
20 _
�nt the sde
�itade axne(t
Yes ❑ No
Nis dadu0iu� Oeen leVUrste� m poputy
um,vn Y�aR r-i .. r-�
��
.����� n.,_ I °� `",�Y �o -1 Z�
.
and cortea arM ihat the applicant is a resident of IrWiana aM
Date (nnnCt day, YeaA
Oate (mmtli. daY.Y��