HomeMy WebLinkAboutMortgage_Griess^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
: FOR DEDUCTION FROM ASSESSED VALUATIO� ��
• State Fartn 43709 (R11 / 6O9)
S � P�esvibeA by OepartmeN oi Lomi GovemmeN Rnance
File Mark
wsrRUCnoNS: r�� '(�
To 6e filed in person or by mail wiN the CountyAudito� or Counry Recorder of the county wFi}i��m�p�y � locafed. F�"" �� �'
Filirg Dates: 7) Real Property: Must file dunng Ne year for which the deduction is sought. ,�¢�'Cl2) �ounry Audimr
2) Mo6Re /Manutactured Hwnes rrot assessed as Real Property Must file d�in�hv _ V onths
before March 31 0/ each year the deduction is soughL ❑ County Remrder
See reverse side !or addilional iqstr�fions and 4�Ifications. _ . _ _ _ _ . _ _....�., . � n o
���
a�,��/ c� �
WhBl IS hISI hG C%'dfl ShdfB Of IIIf2fE5t?
II fwne on �eard'S QAferen� Nan ihat W appOwrt, uM&ate Eeb�r.
Name M mort�a9ee a contraU se9er \_l �
AtlAress of mort9agee w cantract seller (mnnbe� and st+eet . smte. aM
Name ol assignee w aher owner a
AEdress of assgnee (number aro
Does epplinnt own property ir
munty in IMana? r
L
Deduction apprwed in the amount ot
�
I/ We ceNfy under the
ownerlcontraa buyer
�
Dt��fel ��T�. �
Ca�'�r\'p �l�••.
f��,, �3�Z G .
� N- .
perjury that the above and
;mentioned property on da
�v✓wv� �- lv�,
dres ot app(�nt (numDer an0 shx
U� S S zs
!etl by Eidy eze�uteG Power af Attn
m0e)
Pddress M auUror¢etl person (num0er arM svee; tlry, Yd(e, and LP code)
� rd number Page numb�
- 3 t�- ! o od I 3�5
az W Mongage I Co debtedness unpaid as of Is the aDd��� Ne sok
�ate of appli�ation legal n epuitahle mmeR
� ❑ Yes ❑ No
axned wiN someone other than sDa+�. indkate wuh vAam
Caunry
.3 DSVit�1?
R
2� _
property in QuesSU�: Mmu%ASSesv:d
eaI Property ❑ Armualy Assessed
Mobile Hort�e (IC &1.
Na5 �his EeOnd'qn Deen requeSteE on pfOpeM1y
fw artent yeaR �,_ �
20
Date (monUr, daY• Y��
20 _
�nnalion is We and correct and Nat Ne applicant is a resident of Indiana aM
is filed.
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