HomeMy WebLinkAboutMortgage_Reed (10)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hip ar
�_ .� FOR DEDUCTION FROM ASSESSED VALUATION
• State form 93709 (R11 / 6-09)
� P PresaiGetl by OeP��rd af Local Govemrtrent F(arce
.u.
�!NSTRUCTIONS:
To be filed in person w 6y mail wifh the CountyAUdifof or Counry Recnrder of the counry wheie the pioperty is located. F� fl� ��
Fi/mg Dates: 1) Real Pmperty Must file dunng the year /w which the deduction is sought. �� i��
2J Mo6ile /ManulacNled Hanes rat assessed as Real Prt�perty Must file durirg the (weNe (12) months �
before March 37 0! each year tAe deducfion is sought. ❑ Coun Ra�der
GI S
See reverse side for addAional insNm.tions and qualifications.
AppGqn��ownerwcontpctbprer-ue2st{ictionsonrevqrsqsiCe) �
a�, - - - ,
as of Mo�age / ContraG intlebtedness unpaid as of Mwl
Marti17, ayrtem yem tlate
no, what a his / her e>ad slwe of
It narne m�ecptl's 6fternnt Ihan that of applicant u�dicafi beWw
stgagee «mntxt se0er
�
rtprtqagce a mntraa se0
smiee m m�er ovmer or h
s1ree4 mY. slate, aM ZIP tode)
Dces eppl&ant own property in any olhtt
munry in IM�ana7
❑ Yes
oee�� avwwea m ure
20 _
SignaWre ot Co�mN Auditor
20 _
� �. � ��Q
as ol Is Ne appfranl the sole
tegal o�/ e-,m,�+���de v�nerl
�yres ❑ No
tt owned wiih somew�e dher inan spouse, intlicate wiM whom
If yes. what county.� I NTat Ta�dr
couNrr auorrort
20 � zo
Caunry
�Is Pert1'inVUesGm:MnuaMASSessed
I ProGerry' ❑ Mnually P�
llrawcr 1`O...CIt�`.........
Cai-d NO. ...��� .........
iy�j,�l'� •
20 _
29 _
Date (rtmf�. dfi: Y��)
�
I/ We certify under Ne penalry of perjury Nat Ne above and foregoing inforrtwtion is We and cortect afW Nat Ne aDW��t is a resident of Indiana arM
owner I contrad buyer of Ne aforementioned property an date applicatbn is filed.
inaWre (amieYS lutl narn� . Date (rtimuh. daY, Y��
and ZIP m0e)
exewte0 Power of ALLwnay w by IC 61.1-12-0.7
of autha'ved person (numberaM saeet. ciry. slafe.
daY,Yea�