HomeMy WebLinkAboutMortgage_Shackelford"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
;�_ . FOR DEDUCTION FROM ASSESSED VALUATION �
• $tdte Form C3709 (R71 / 609)
� � Presvibed M�nmeM o( Lacal Govemrtrerit France
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wsrRUCnoNS:
Fwm fded wiN:
To 6e filed in person or by mai/ with the CounryAuditw or Counry Recorder of the county wFiere the property is located. )
F7irrg Dates: 1) Real Pmperty: Must file dunrrg the year (or which the detluctan is sought D��—Co �n(y�quditor
2) Mobile / Manufactured Homes rrot assessed as Real Property Must fiie dunng MB tweNe (12) months ❑
before Ma�ch 37 of each year the deduction rs soughL Counry RecoNu
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See 2verse �e 7of edtlrtionel inshuctions and qualifications. n '/f ' �
MMm^�(o arooraractbuYer- �iestncnp�mB�erseside) aY� L A�8 tlN tl6UNfii' A_[ilfE�1 .�.R �
A� value d mal qoperty as W
Mazfh 1, Nmstl yPar
no, wtat is ttis / her ema
L
of mort9agee a mntraG seller
Key num legal desaip
,. - �'� -f� I _
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e
Address W mwtgages or mntran seLer (nuMer end sLee; raY• 5am,
Name M assYyiee or dlws ormer or hdder af rtKrtga9e
Pddmss ot asse�ee (number entl streeG rdy, sfate, an0 LP �
Ooes applimm o�m propeny in any oNer
muHyinlrW'vna7 ❑ Yes
❑ No
DeEUGion appraved in ihe amount at
2o i �_
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o�-�„����.io...ao�o
Ca�-� ��o. ... Sy9a.........
�a53, 000. a�
Is ihe apPlrcant the sde
kgal «equitade wmer?
❑ Yes ❑ No
spouse. u�d�te witl� xiwrn
Is the property in Ouestion: MnuaPf Assesutl
� Real PtOPeKY ❑ %+!�!���1!�
Hat Nis tletlutlion
for arten� yea(�
�_
ste0 an pmperty
Yes O No
�� �,�. �y ��
zo_
I I We certity untler the penalry ot perjury that Ne above and foregoing in(ortnation is we and cwrea arW Nat the applinnt is a resident ot IMiana aM
ownpt I mntrad buyer oi the aforementioned property on date ap0��don is filed.
Pr�san auNm�d Dy Ouly
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�e4 �'iry. stata. ard
(num6eraM sbaeL �Y. state. end LP wde)
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