HomeMy WebLinkAboutMortgage_Nellis"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_, + FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (Rtt / 6-09)
� j Revribed by DepartmeN at Loral Gwemment Frence
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�u.
STRUCTIONS:
o be fited in person w by mail with the CountyAuditor or Counry Recorder of the counry where the propeM is bcate� C T
Filirg Dates: 7J Real Property Must fife durirg the yea� for which fhe deducUon is sought.
2) Mobde / Manufactured Homes rrot assessed as Real Property: Must file during the iweHe (72) montlLa �
before March 31 of each year the deduction is sought.
See reverse side (or addifional instrucUons and qualificatrons.
AnMirani(owncrarconvartbuver-seere mreversesidel..e '
County Auditnr
�CounN Remrder
Distrirl Key numDer / legal description Record number Page numDer —
a� - 7-/7 - iD0-oo/. �,3 -o �/ 3q ��
eE d real of Mortuage / Contraa intlebtedness unpaid as d Mortgage / Conva<1'uWebiednrs unpaid as d Is Me app�nt the sde
I, year Mard� t, wrtent year date of eppficatim legal w equitade oxneR
DO D ❑ Yes ❑ No
�18i 6 �VS � iM! CXdL� S�1dI8 Oi Il1iPR5l� �� ONT2d WII1150TC0lIE OUIBf pldl150MISC. YIdIWiC WII71 W�IMI
i m mmN's NRuent lhan Nat of aPP�• uWir�ate 6ebw. Is m Vurs�m MnueOy Assessed
Real RopeAy ❑ Armualy Assessed
Mobile Home IC 67.1-i
N mwcgagee «mntrari seller
s d rtiortgagce or contraG se�er (n�niber nd sbee4 �T; sfate. ard LP cade)
Name W assignee w other oxner or hdEer of rtprtgage
20
(numGer antl strec4 �: slafe. antl ZIP code)
N� ��-3-�a S�c
voperty in any oNer If yes, what munf/t VYhat P.
amounc of
�
I/ we ceNry urWer 1he penalry ot
owner I contract buyer of Ne aton
W?nue (ownerT h�l rer�q) ,,,�
Z
Dra�� er NO.... ���.......
� c1,�� ��o. ....39�3
. . ........
COUNTY AUDfTOR
�Jr/6L'D.l�
2Q _ 20 20 _ 20 20
Caunry Date (rtaW. Qfi: Y��
that Ne a e and foregoing intortnation is true and cortect arW fhat ihe appluant a a resdent of I�diana aM
ned pro0 on date ap0���lion is fiied.
fSl risiEent aEtlress of appfcant (num3arantl sbee4 dty, state, aid ZIP code)
G576 S// .S—D cCJ ocv��✓� LLC �N �f �
Person auNO�rzeE �y Euh/ executetl Power of A[tamey or by IC 67.742-07
person (numDer antl sUee( tdy. state.