HomeMy WebLinkAboutMortgage_Smith (14)' '� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION �
State Fortn 43709 (R8 / 2-07)
�' �� Presaibed by Department of Local Govemment Firence
File
INSTRUCTIONS:
ro ne firee �� ��� o. ey mav Wrtn r�B co��ayn„a;ro� w�ne �„ny wna,� ma P�P�y rs ro���. FEB 1 Q 2p09
Fd'a�g Dates: 1 J Real Property: Dunng Ure 72 monU�s befare June 11 d fhe year the deducSon is to be eRec6ve.
2) Mobile Hames assessed under IC 6-1.1-7: Belween January 15 end March 2 0( fhe year the deductionis to be e9ective.
See reverse side for additional instructions a�d qualificatbns. �� ��
(amer w mnhad buyer -
+. a.,eru rmr I �9e � c
artent year
is his / her exaa share m
If reme m recmtl
Adtlress of mongagce « cmUaa sdler (numbu aM s8'eeG dry.
Name of assgnee a other o.vner or hdd� of r�w�gage
PAdress of asdgriee
Dces applican� own property in arry ather
caunry in Indiana?
❑Yes ❑No
DeduUion appmved'm Ihe amwnt of:
�
SignaWre of Caunry Audilnr
0
LP code)
arW
If yes. what counh?
20 _
I/ We certify under the penalry of perjury that the above
Indiana and owner of ttie aforemenfimed property on M:
�te(oynerslunname) �� �
(n�mber end sLee1 cAy. sUfe,
of Altomey w by IC 61.1-12-.07
person (numberarMStreei. cify, stafe, a�
�
unpaid as
—O�./ % `.� d
n i, is u�e aaremm u,e sde ieyai o. ew�+�aa o,men
❑Yes ❑ No
If owrretl wiih sortieane dher �tw� spouse. indwte wi�h wMm.
is Ihe propeAy in question:
❑ Real P�operty ❑ Mobile Home (IC 6-1.
Has �his deduclian been requestad on yaperty
for artent yra/7
❑Yes ❑ No
COUNTY AUDITOR
D ra,r�e r N o�?�. 9. -..�J. .— �.
C3rd NO . .....................
� II %� S 00, °�
20
20
pplipnts was / were a resident of
Dafe (matlh. daY. Y��
day yea�