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HomeMy WebLinkAboutMortgage_Lance.+°•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year _ FOR DEDUCTION FROM ASSESSED VALUATION �� State Fartn 43709 (R8/ 2-07) S„N 1 Presmbetl by Departmenl of Loral Govemment Finance File Mark iNSrnucnoNS: JUL `L 9 ZU08 To be filed in person or by mad wifh fhe CountyAuditoi of the county wheie the property is bcated. F�'mg Dates: 7) Real Property: During the 12 months before June 77 d the year the deducfion is to be eRective. 2) Mobile Homes assessed under IC 61.7-7: Behveen January 15 and March 2 of fhe yea� the deducGw��i y'¢�tp be e�L�ve. See reverse side fa additional instructions a� qualfications. `� � (owner ar L Marth 1. amr.nl y�r is his / her ecacl share M interest? If reme m recorE is tliRerent Ihan thal �ll -a9-1 rn -oc� .'�7-c�3- J Reoo�d�ba5 P � 1 � � / CJ 7e / Co]�.�f indebtedness unpaid as of March 1, Is ihe appliq�t Ure sole legal a equifade onneR year iX�7 T 7l � /�R`1r'1 ❑Yes ❑ No Name of mortgagee or cantract seller /' `�l. Address of rta�tgagee or oonlraG seller (number aM street. dty. state, aM p W�er owner or holder of mwlgage ot assynee (rnnwe. and so-eef, dry, srate. and z�r mce) Daes applicara wm propertY in a�ry anu courLLyin Indiana? ❑Yes ❑No Deduction appmved in Ihe amounl of: � U"( � 2p L/ � t f /WdM� I / e certi und Indiana and o of th I �5� we o ers nanre) lent address ot applicant �����i����< Person aWha¢ed by duy arzeaL Ii rnmed wiTh someme dher �han spouse, is Ne propeM in question_ ❑ Real P'operry ❑ Mobile Home QC 61. Ifyes.whatcounry? lM�-•' , /1��1 � ( 2.�0$ '� ` `, .�•'y.,+�' " •.J .�� ��� �� `O�' i '' 20 _ C,�� \� `O • - _ : dedudion been requested on property �� y�n ❑Yes ❑ No 20 20 Date (�q(FLddY. Y€a� n of perjury fhat tl� above and foregoing in(ortnation is true and mrrect and tlial the applicznts was I were a residen[ af nCnfioned Dropefly On Ma(ch 1, 20 state. aM ZIP Power of Attarrrey or by IC persm (num6eraMstrcef, ����a��-0