HomeMy WebLinkAboutMortgage_Deal (8)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
__ _: FOR DEDUCTION FROM ASSESSED VALUATION
Stafe Foim 43709IR11 / 649)
,,,,, � PresaiheE by DePa�rrt of tn�al Govemmerd Fuance
INSTRUCTIONS:
b 6e filed in person or by mail wifh (he CountyAUditw or Counry Recorder of Ne county where the property is located.
F7'ug Dates: 1) Real Pmpaity: Must file durng the year (or which lhe deduction is sough[.
2) Afobde / ManulacNred Homes not assessed as Real Prty�erty Must file dunrg the twelve (12) monf/�.� �
betore March 31 0/ each year Ne deduction is swnght.
See reverse side for a�tlilional inshuctfons erM qualifications. n
�AVWmm(owner�r D`ryq` a°°- - �' . _ _. _ n A r �
�
sl�ara ol interesCl
Mpr(p ge / ContraG intlebtedness
Memhat. artent�ra�..
rc„ame a, �com �s ame�,� w� ua� or aov��t �+e�r� eeww
Name ot rrortgagea m m�uaU xller
nvtpage
Pddress ot assi�J�ee (numeererd sheet cib
oaes e�m own p(openy in em �
couNyinlMana? ^/
L `
V
��� �� �o�` n
-�,�``'� �� � 3
� � J
Il.
/�\�1� ..ry of Perj
u� se afaeme �
a)
�esitlentaddless
as W I Mon9a9e I Conrad trMebtedness unDaid as
date of appOtatian
�
5 ��ha�,a�
, Caunry Remr�der
�
Ls Ne eppG�t tlre sok
legal or equirade mmrli
❑ Yes ❑ No
I( awrreE x+th someone aher ihan sGa+�. mdKete wiN vAmrn
ee; ciry, s�fe. aM'LP wde)
'lPcoda)
wha[ muntyi W�at Taring Distr'v1?
� COUNTYAUDROR
A 20 _ 20 _
Is Ihe propucy in question: Mnua�y Assessed
❑ Rea� Propenr ❑ Mnua�N Assessed
0.lobik Hmte (IC 6
Has Iha deduction baen repunsted m ptoprlty
for artmt YeaR 1"1 .,_ _ I-'1 �
� � �
I�nry JhJ�'� 7�`—' I�(�`'v �I v
above and foregoing infortnalion is We and cortecl arM that Ne applinnt is a resident ot Indiana anE
�erty on date appliption is filed.
Data (maafi, daY. Yge�
ary, sfate. aM ZIP
ezewtetl Pawer of ARGmey or Cy IC 61.1-12-0.7
Add2ss ot autlmr'ved prlson (num0er eM shaeL �4Y, s+ate.
r
! -----------��-
�l: 3��
\