HomeMy WebLinkAboutMortgage_Murnahan""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ , FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (Rt t/ 6-09)
, w• � Presaibetl GY DePartmeM of Laml GovemmeN Firence
INS7RUCTIONS: ,�+�
To be filed in person a 6y mail with the CounryAuditor or County Recorder o/Ihe counry whe2 fhe property is locate� P R F�LU 1��
F7'vg Dates: 7) Real Pmperry: Must file dunrg Ne year for which the tleduction is sought. �� Counry Auditor
2) Mo6de / Man�factured Hortres rrot assessed as Real PropeRy Must file during the fweNe (12) montF� ,�
before March 31 o/each year the deduction is sought. County Recorder
See reverse side (or addifionaf instnxlions arM qualifications.
I MP�� rv contraC buy�er- see restri�yons m reverse side)
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I Taring �istrict Key number! le9al desaiption Remrtf rwmCU Page raunbu
b-l�-o�-la�-000. i 93_oai 10(� 8.�
Asea.ed ue af mal as of Mortg�ge / Contraa inEebtedn¢s unpaid az W Mortgage / Contrar2'vMebtetlnrss unpaiG as M Is Ne applinnt Ne sde
Ma'ch 1, amnt Ypr Ma�U 7. currenl YPar Eate of aPPli1ation kgal a eWttade owm�
1 �. �% ll � %i ❑ Yes ❑ No
�z :�
tl rurtc an remE's �tFere�ft than Mdt W applranf, rtMirate bebw.
Name W rtnrtgagee or contrad seller
Address of rtnr4�agce ar mntrad se0er
dhg owner or
Does ePWipnt avm DfoVenl''v/any �
munry in Ind'ana?
❑ Yes
DeGUCtion apprwed in Ure amaunt of.
bei and sbeeG ciry, sfate, an0 e
morigage
s(ate, aM ZIP codg)
liC..�L.iw
I( yes. what munt�?
I No
ZO � 20 — � 2b
I/ We certify under the penalry of perjury t the above
owner/lcontraG 6uyer of ihe afo2men �e� ed property o
Sigrew"'(o e me
�
F�A �evdent address of appficant (number antl sbeet dN, �le, ai
��z� ����,-� ��_.,��
Pereon authotrzed Gy duly es Power of AttaMy w by IC 61
svouse.
� V�PeM in questiav MnuaOy Assesud
Real ProPertY ❑ PmuallyAssessed
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vmatiap�yo�o-�? C:11'(� 1���. ,,.'"U�J
fYAUDROR `� � 57, 843�"00....
20 I 20
20 I 20
regoing intortnation is We and mrtect and that Ne appliqnt is a resident of Indiana arnf
application is fiied.
Date (rt�fi, day, yaar)
person (numbel and sneeG �Y. s+ate. antl LP cde)
��,:,=..-c.,.LL_ �'V
Date (month, Gay, yaa�