HomeMy WebLinkAboutMortgage_Puckett.�F��A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
= FOR DEDUCTION FROM ASSESSED VALUATION �
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State Fartn a3709 (R8 / 2-07)
��' ; � Presuibed Dy Depahmenl o( Local Govemment Firiance
Filep Mark
INS7RUCTIONS: ZOOU
To 6e filed in person or by mail with the CountyAuditor o7 the county where fhe property is located. AU�] 1 9
FJing Dates: 1) Real Property.' Dunng the 12 months be%re June 17 0/ fhe year fhe deducfion is to be elfec6ve.
2) Mobile Homes assessed under IC 6-7.7-7: Behveen January 15 and March 2 o(the year the deducbon is to b Hective.
See reverse side fw addi6onal instruUions aM qualifications. � �� �t�j
sessea vaue ot rea qqpety as rn ry
V �
' whal is his I her exact share of i
reme on recnrd is differer4 ihan 1ha
ame of mortaaaee or conl2U seller
s on
number I le
-/0 �0
,.��,�,�� ��a i � c�
art
applinnt. iMimle below:
Address of rtartgagee w cmirap seller (numberaiM streef, oty. stafe, and ZIPmy
�
Name of assignee «dher o.vncr w hdder of mortgage
Address of azsgnee (number and sheef, city. stafe. and ZIP wde)
Does applicant own properly in any dher If yas, whal muntyT
coun�y in Indiana?
^ n .,_
Deduction appro�
20
0
I / We certi under
In � nd owner
� lwe( ne/slWin
FGO s' atlOressoL
as of March 1, � Is 1he app5ont Ihe sole
If o.metl with wrtieone olher ihan spouse, indicate with wMm.
ya3a�-
a. equiUae owne/?
❑Yes ❑No
Is Ihe properry in question:
❑ Real ProceAV ❑ Mobile Home (IC G7.
Whai Tacing Disiricl? I Has
far c
ITY AUDITOR
Drawer iVp,a n.0 �_ .�31 y
ueslcd on property
❑ Yes ❑ No
C'� �� �rO. p .�• 20 ' 20 20 _
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%! � � �/ / � / .�� CourHY Dalel��day'e�O—�O
�7
penalty of pe Uiat the above and (wegoing infortnation is We and cortect and thal the applicants was / were a resident o�
fhe�en6op�rope�y on March 1, 20 _
� �� r_ �
of Attaney or by IC Gt.1-12-.07
AdCress of authorized peJSOn (numberantl sbeet, dty, sfafe. aM
oa�e (ma�u�. eay, y��
r
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