HomeMy WebLinkAboutMortgage_McClure (2).►^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n h Year
°i . ' FOR DEDUCTION FROM ASSESSED VALUATION J
�' Stale Fwm 43709 (R8! 2-07)
Presaibed by Department ot Local Govemment Finance
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INSTRUCTIONS:
To be (led in person or by mail wfth fhe CountyAuditor o/ the county where the properfy is located. � ��
Filing Dates: 7J Real Property: Dunng the 72 monUrs be/ore June 17 0/ the year the deduction is to be ef(ective.
2) Mobile Homes assessed under IC 6-1.1-7: Belween January 15 end March 2 o/the year the deduc6on is o be� g a�pi1OZ
See reverse side /a addifional instiuctions a/M quali(cations. G�BSON COII%��Y
mnVaQ Duyer - see re ons m reverse
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Tabrg Di 'ct Key number / legal descnpUOn
ax �- - lo - /00 - �O/. o� - �
rdue of real poperty as d March 1, w2nt yaar Mortpage ! CorNad iMeWetlness unpaid az M March 1. Is Ihe a�
curtentyear /� � / �, g5a
�0
"��, what is his / her e�cacl share of iinerest? If owneC wilh someone dher Ihan spouse,
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Name of rtaflgagee or coniracl seller
Address ot moM1gagee w cmVad seller (number erH street, tity, stafe,
oUrer o.vner or
epplicant own property in any other
y in Indiana?
❑ Yes ❑ No
ction approved in lhe amount of:
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and ZIP cotle)
If yea, what counry?
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Pag�
/
❑Yes ❑ No
peM in quesUon:
Property ❑ Mobile Home QC 67.
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_ ��°Cl _`:-'F7 � �
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Wh /� � � //�� .. ated on P�PaM
C „Q6_ Q � j�l '� �Yes ❑ No
—`•_•C.! � � � ��'C.S�L
�y m
COUNTV AUDROR L,S`p� S
6i�
Cwiriy
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oate (monm, eay,
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II/ We certify under Ihe penally ot perjury that the abwe and foregoing iniortnaGOn is We and correct and that the applicants was I we2 a resident of
Indiana and owner of the afwementioned propeAy on March 7, 20
yI� Sig en(o�wne/s/ �IW/�{�ra . Date (�+N. deY• Y�A
1'� �/Xn� /' \��/�/
esi enl address af applicant (number end streef. city, s(afe. antl Z!P rode � ,/��
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Person authonzed by du y exewted Power ot Altnmey or by IC 6.1-12-.07 oare (mmm, eay, yea�
Address of aulhwaed persan (number aM sLeeG aty. sfafe. aM ZIP oode)