HomeMy WebLinkAboutMortgage_Taylor (9)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
' .._—..
; FOR DEDUCTION FROM ASSESSED VALUATION
State Fwm d3709 (R11 / 6-09) � � �
��' y„ ° PreuribeE by DepartmeM of Loral Govemment Frence
File Mark
wsrRUCnoNS:
To 6e filed in person or 6y mail vrifh the CounyAUditor or Counry Recoider of the county�p��y h9 prppyy located. F�' m� �'
� F�Nrg Dates: 1) Real Property: Must file durirng the year Por which fhe deduction is wughG~U V 1 1 L U �� � Counry Auditor
2) Mobde / Manufactured Homes not assessed as Real PropeRy Musf fi!e duriny the tweNe (72) months
. 6etae Ma�ch 31 of each year tAe deduction is saght C. J, � ❑ County Recorder
See reverse side`oradtlitional instn�cGons arM qualifications. V�
npp�wnt` ror �buye�-seerewi�t�nsm si�) �^ 5 NTYAUDITOR
Key numGer /
As¢seavAUeare21 f e
� 7, qaRnt Ma 7. �
tt ro, what is his l lcer e:aq shara of intgest?
tl fwre m'em�d'a diRuent ttan Nat d aOD�� uW'uate Gebvr.
Name of nqrtryagee a mntrar� SeYv
mortga9ee or cantrad sWm (mmDe� aM streeC �Y. stafi. aM
mortaape
neare � DI I .
D1'115'�1' �i�..�......
pces ..... .. .. inty.�
coun •• • —
Card i\'O. .....°.�.�� �......... —
i � �c��,�,� —
20 20 _ 2(1 �
3�7
�3�J�. _/S� `aa� � 1 � i
unpaid as W Mortgage / ConVa(Y'v�deMetlness unpaiC as d Is Ne applirvnt Ihe sde
/�?� date of appGCation kgal w eQuitable amef.+
✓lJ ❑ Yes ❑ No
tt owned wiN someona othar Ihan spouse, indirate with �Nmrn
WAat Tadng DislriU?
20 _
property in quesnon: MmiaOy Assesse0
eal Roperty ❑ MtnuallyAssesSed
Has Na dedursion Eeen requesteA on pmperty
(w wrrent yea(.� ❑ Yes ❑ No
20
Date (momh, daY Y��)
20 _
I/ We certify under the penSlly o( per�i y thai Ne above � foregoing infortnation is W e and cortec[ a� that the applinnt is a resident of Indiana arM
wmer / contracl buyer ot the aforementioned pmperty on te appliratlon is filed.
7re�➢ (flA'^?ri � ^a�➢6)� / Date (rnonfh. daY. YfaA
�
�Y.Y��
P4dress of aWraaed permn (num0eraid stree; c#y, state, aM ZIP code)