HomeMy WebLinkAboutMortgage_Trotter� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ FOR DEDUCTION FROM ASSESSED VALUATION
Sbta Fortn 43709 (R11 /6-09)
�' Presmbetl tr10ePartmeM of I..oml Goremment Fnance
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INSTRUCl10NS: . F�
b 6e filed in person or by mail with the CountyAuditor or Counry Recorder o! the county where the property is located.
F�7irg Dates: 1J Real Pmperty: Must file duntg the year (or which Ihe deduction is sought.
2) Mob�1e / Manulactured Homes rrot assessed as Real Pioperty: Must file dunng the twelve (12) months �^
6e/ole March 37 of each year the deduclion rs sought. ���4
Sae reverse side for additional instiucGOns and qualifications.
IAppfirant oraontraC6uyer-seeresnictiore si�) •
� ! �
' Ta � Key num6er / le9al CesaiDtirn Retord ��mbe�
_ U'J, �O� o�- CJ�/ O io
Aaessetl d� p�opeY.y a at Abrt9a9e / Coniraa'udebtedness unVaid as ot Mortgage / ContrafY mdebtedness unPaid az of I
Ma�d� t, am�nt ytar Ma�U 1, wrtenc yeer date of appG�atbn /1 �� ___ �
U � ,
I( no. whaf's his / her rsarl
tt fwrie on mmN a dirterer
Name at rmtga9ee or mntracl seller
ALdress d mortga9ee ar wntract se0er
Nama of assignee or W�u wmer w hd
Addrew of assignee (numbe dr i sfree
�2M orm property iri any oNer
tiana?
❑ Yes
app�oved'c� tlre amoun[ of.
appdcant, i�Mkate bebw:
�a� G u!Y sbte,
er of moriga9e
�, slafi, a LP e)
If y , wha[ co
❑ No
2p � 20 � 20
,��,
tt awnad wiN someorie aher C
CAUNTY AUDROR
20 _
�,�
� I/ We certify ufWer the penatty of perjury that the above aM foregoing infortnalion
owner / contract buyer of the aforemerrtoned property on date applicalion is filed.
re (oxnefs hd ) ,
� .L
�/ FW 2sitlent address of appficant (number ard stree4 ti, sfare, antl LP code)
�� ' c�'I� ' (.d - �
Persm aufMfaed Dy Guty �ewted Fwrtr of Atbmey w by IC 61.1-72-0.7
Pddress ot autha'¢ed person (numberaib s�eeS �'+�Y. ��. aM ZIP code)
�f3�
: apFBrsnl tl�e sole
ar eqUttable o�v�Y+
❑ Yes ❑ No
�e property in Question: Mnua0yAS5essed
RealPtoPeKY ❑?^^!��Y�
Has Nis detlu�
far w�rent YeaR
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Dra�� er \0.......
y��3 �
.
Cai-d \O . ....................
� � y,c�-`"�
��,�. �
m piopefty
❑ No
3na arM