HomeMy WebLinkAboutMortgage_Deen^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun o sh p e
__ s FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 6-09)
�,�,� � PreSOibaE by DepartrneM of Loml Gwemrtrerrt Firence .
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INSTRUCTIONS:
To 6e filed in person or by mail with the CountyAuditor or Counry Recorder o( fhe county where the property is located. F �
Filirg Dates: 1) Real Ploperty: Must file durirg the year for which Ihe deduction is saught. ��ty(�
2) Mo6ile / Manulactured Homes rrot assessed as Real Property Musf file dunng the tweNe (72) months OI S O�TY AU IfOR
before Malch 31 of each year the deduction is swght County Recorder
See reverse side 7or additbnal instructions end qualdicafions.
I Appfimnt or oontraU buyer- see msfiUiorts m reverse side)
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I Tari Distrit Key bu I leg I tlesaiption Reco�d number Page wmbej
-Qi-�.�3.�a3 -�a � ��
IAanseC raWe d pfoperty es ot My(�yg e/ Contraa "uMebteEness unpaid as o( Mortgage / Canvact maebteaness �mpaia as ot Is the ap�t the sok
Meich i. anrnt ymr Mam}� ti'' t date of applmation legal w equilade wmeY1
/ � ,5 �� ❑ Yes ❑ No
� fl m. what is his / tm! e�r1 sha�e ot intriest? tF owned vrith someone dhu Ihan spouse. iMicate wkh whom
If �wne m remN is ddfetent Nan
tJartie
rtqrtgagee or contrad se0er (number ar�stree; cdy, state, aM LP oode)
w othu awner w halder M mortgage
ot assgnee (numcer am suae; wy, srdie, em ur cooe�
pces apd� � V�PeNY �n any aher
cou�LLy m InEena? ❑ Yes
Dr�ucOOn aVW�'� ui �he amount .
20 20
Sigretlire W Coimb Auditcr
� /O� COUNTYAUDROR
20 _ 20 _
Counry
eerty in QuesOm: MnuaDy Asussed
Property ❑ amuanyasse.ssed
MoWle Home (IC 61.
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DI'fl11'CI' \�...�0/i�.......
5 ��2; -
ca��a �o . ..................... i No
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I/ We cerOfy uMer the penalry ot perjury that the above and foregoing infortnalion is We and cortect arW Mat Me appliran[ is a resident of InEiana and
owner / mntrad buyer of Ne aforementioned property an date application is filed.
(utl nemH� Da1e (rtmtl�. daY• 1'�A
EW revdent atltl�ass ot appluani (numDer an
G.s� �.,,�� 5�,�� G,,
Ppnon aufto�izeE by tlu ex af
AEtl(CSS Of 2udrofQ¢d CeR� (lIIIIMB! 3M 5
rily, 5late, eM ZIP ootle)
7c.�l•rSv. //� �N y
r or by IC 6-1.142-0.7
stare,