HomeMy WebLinkAboutMortgage_Compton (2)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C n T hi ear
FOR DEDUCTION FROM ASSESSED VALUATION
SlaleFartn43709(R70/i1-08) J N 2 3 2009
� , R'esaibad M' �rNient d Loral GovemmeM F'v�anoa
INSTRUC710NS: Fle M/a/fkyyy
To be fded in person a by mad witlr Ure County Auditor d the oounty wheie the propeRy is loceted. �%y� T✓ �
Filirn7 Dates: iJ Real Pioperly: Must Ide d`sirq fhe year /or which the deduction is sought.
2) Mobde / Manufectured Homes nd ascessed as Real PropeRy: Musf fde dunig the (weNe (12J mo6BRSi677W�Y1318TOM�pTjO@I
fhe deductirn is sought
See ieverse sMe tar addAional7nsWdions and quelifications
Appl'icam (ownaor con4ad D�rydl �i&f��°^s °" �°�� �) /�
�
hB
nber/lepaldesaiption /
-17-a-9- oo-000.a
Mortg�ge/ CmiraG hde6ted1ress unpaiG as d
MarU� 1. curr� Year , /
� �'7 n �d .S . �n Y
tl rema on reartl is Q'AfareM ihan Ihat of aPG&snl, intlimte below^
Name d mortgagee or rantrad seAer
neeress w mortgagea or
s
stala, antl
Addrass d asignee (m�m6e� an0 sbeef. rdY, sAfo. aM LP cotle)
Doas appGCant own p`ope�ty in ary qhar tl yes, what muNy7
�Y � ���7 ❑ Yes ❑ Na
�'��i��Z��ii9
20
/,Od-( �}-00 g I %
lage / Cantmd indebtedness wQaid as d Is ltre app�icanl Na sde
�f appGration legal ar eC�'aWe arne(/
❑ Yes ❑ No
OTBOIIB WIBf IM12fl SGW�. PNIfdIB MIIIII Wpfll
Is �he Wo7eM �^ auastim: MnuaM0.ssessed
;� Real Properry Q Mnually Asser,sed
MahOe Hort�e fIC 6
! C�V �� ��
Dra���er \0..�'•��.......
o� %�
— Cal'CI\�.....��.I"•........
— �35,01�5• �°=
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I I We certify unda the penalty of pujury Mat Ne above and foregdrg 'v�famation is W e antl carecl and that Ihe appOCant a a resdent af Intliana and
owner! mntrad buyer of the aforemenibned properry on date appli�ation is filed.
�um (ownrlslyQ"a^"el�'1 C f Oate (nrontr+. eay.loa�
duy erzeated Power of Nbmey n by 16 67.
Address of aNMnZOd person (nvnAV and sftmt, Cdy, sbte.
Date (imnlh. GaY• Y�)