HomeMy WebLinkAboutMortgage_Deal (7)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (Rii / 6-09)
�,,,� f Prescibetl t1' DePartment of Local Govemment Flrw¢e � .
File Mark
INSTRUCTIONS: �PR Form .
To be lled in person w by mail wiN [he CountyAuditor or Counry RecoNer o/ the county wheie the pioperty is locat
Filirg Dates: 1) Real PropeRy: Must file durirg fhe year for whifh the deduction is wughG �Counry Auditor
2) Mo6de / ManuFactured Homes rat assessed as Real Prtrperty: Must file during the fweNe (72) montl�s�
befae Ma�ch 37 of each year the deduction is sought ��jp .,Counry Recordu
V
See 2verse side /oradditional instfuctlons and qualificateons. p�BSON COUN
Appkant (owxr mmurya�uyer'see resnic°°1s °?.Rit�T �) 1� ... . � n . .. ..
her exaa share o( int�est?
- l \ - — b.�+-U
gage / Contract'ude6tetlne55 unpaid as N Morigage / Cantracl indebiedness unpaiO as of Is Ne
7� 1, airtenl Y�� date o( aPP�� �Ja�
If owned wiN samrorre other Ihan spouse. udifate wiTh whan
If rwne m remrd is 6ltemnt Nan Mat ol app&ant, Ind'uate Debw.
m
�eaaa
(numaer ene so-eec �r. sale. arie z
ooes epWrcam ow� wooertr N a,y oma
munty ui InOiana? I"I .,' _
Deductlon appmveA in ttre amount
�._ �.
Sig�nne d Camb nuCimr
�m,
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- C81'(1 �i�. ... ��0�-�
i 8?� 35� � ��... . .. .
p --
awneR
❑ No
p�operty in purstion: MnuaOy Assessed
eal Pmperty ❑ ArmuaRy Pssessed
Has ih'a deductim Eeen re9uested m
for artent yeY! ❑ Ye5
�_ , �
oa�e �,�o+an. e�r.
I/ We certi(y undu Ne pena f perjury Mat the above ard foregoing infartalion is true and mrtect aM ihat the applicant is a residertt of Indiara aM
owner / contracl buyer ot ih mentio rty an date appikation is fileA.
i�w �r: ) oa� (mmm, mr. rgeA
i
; ' ent p�fwant mO artl yeef, ; state, and ZI oode) ' j�� �/1
S 1%�` � 1 V
rson a�avea M der �ew�ea ad.e. wa�„er «cr �c st.�-tz-0. oace (momn. ear. r��
Address ot auNOr'vetl persa� (numbel an0 sfreet �+�Y. ��.