HomeMy WebLinkAboutMortgage_Huff""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ , FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R77 / 6-09)
, PresaiCed by OepartrreM ot Locel Govemment Finance
INSTRUCTIONS: p w�
To 6e filed in person w 6y mail witlr the CounryAutlito( or Counry Recorder o7 Ne oo�nry where the propeRy is located. Q� y�— L � � �
F7ing Dates: 1J Real Property: Mus! fJe during the year /o� which tha deduction is soughL � County Auditnr
2) Mobde / Manufactured Homes rrof assessed as Real Prt�peerty Must fiie dunng the tweNe (72) months ❑ Cou�ry R��
6efore Malch 31 of exh yeer Ne deduction is sought.
See ieverse side for addifiona! insfructbns and qualifications.
MP���(o�.+re�or 4��a��cstnUio/�mreversq�sqL) . . 1/ �. nn
��
tl fwrre m remtl's Sfiumt tlan ihac of aPP�=. uM'sate Gela�r.
Name N rtnrtgagee or contrarl seller
Address of mortgagce w mntraci snAer (num
Name of assignee w oNer owner or hdder ol
ACCress W esti@�ce (numDer aM slree4 �:
�
sbee4 �1: sb�.
L::�.-u C
Does applitaM ovm peoperty in any oNer
mumy �n Ind'vria?
❑ Yes ❑ N�
amount
Ei���il]
az
2ivcoee)
Nu�'�', P�+r�� A
� ��y k
�ov� - //3(�
20_ � " ev_ .
Caunry
i(WebteCr�s
num0u
w equitade ownell
❑ Yes ❑ No
IS tM property in Ouesbon: Annua%Assessed
❑ r2eal Proaert�' ❑ iwu;aM a�sed
:te� m P�Y
Yes ❑ No
20— � 2tl
Dete (rtpiW. daY,
I I We certify urWer ihe penalty of perjury that ihe above and foregoing intwmalion is W e and cortec[ arW ihat ihe applicant is a resideM of Iridiana a�
owner I mntracl buyer of Ne aforemerrtioned pioperty on date application is filed.
i'q}ue �rxieYS hIDreme) . _. (� il Date (mw+fi. daY. Y�)
Per„on author'¢eE Cy dWj executed Power o(Attarney or by IC 61.1-12-0.7
Mdress of aNfwr¢r� person (num6er arM sbee; dry, sfafe,
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