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.f °'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_. FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R8l 2-07) � � � �
�� Presmbed by Depanmenl of Loral Govemment Firence �.J
INSTRUCTIONS:
JUNe��2008
To be filed in person or by mad wdh fhe CountyAuditor o/ the county where the pmpeAy is located.
Fding Dates: i) Real Property: During the 72 months befae June 11 of the year the deduction is fo be eflective. �
2J Mobde Homes assessed under IC 61.1-7: Behveen January 75 end March 2 0l the year fhe deduction is to be��jp�.�Q
See reverse side (a additional insWt(rions aiM qualifications. (� ___
Jeverse side) �, n o
Key �wmber I legal
his / t�a rxad share
tf rame rn record
moriga9ee or conlraG seller
Address of mortgagee or mnirad seller
� - - -
1. artent year Matgage / (
wnart year
applicant, indinte below:
Name of auigrree a dt�er owner or holder
Address of asvgnee
Daes applicaM wm propertY in arry alher
cauNy in Intliarro?
n.._ n .,_
Deduction apprwed
-oo � %�L - 60
indelxedness unpaid as of March 1,
stafe. arM LP code)
sfafe, aMZlPoode)
If yas, what
��-a�t-c�- �o. 2.°.° �.- �l.t 9 9
� Card NO . .....................
sg��� � a31> 9 ��
If wmed wdh someane dher Uan spouse,
Ta�dng �isUiclT
zo _
1� ber Pag um�
�
�e sae �ega� or em,itawe wvner
❑Yes ❑ No
NIh whom.
Is �he property in quastion:
❑ Reat Property ❑ Mobile Home
anent
rza
uested on property
❑Yes ❑ No
Dale (monlh. day, yea�
20
1/ We certify under the penalty of perjury that the above and foregoing infortnation is true and corred and Nat Uie applicants was / were a resident o(
Indiana and owner of the afwementioned property on March 1, 20
�/[ // n(owne/s !�A /�/ 1 � /� Dale (month, daY. Y��
�� r„^ �/ —ilS.�
of applicaM
Person authorized by duly axewted Pwrer oF PANmey or by IC 61.1-12-.07
persm (num6erarMS6eeCcAy.sWte.
�c��� s
Date (rnanfh. day, yea�
1