HomeMy WebLinkAboutMortgage_Winchester""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS c 4Towo ' ear
_„ ; FOR DEDUCTION FROM ASSESSED VALUATION � � C�� �
State Fwm 43709 (R11 / 6-09) 1LJ
�,.,� � Presaibed by Deparlmertl af Lnml Gwemrtmnt Finarre
File Mark
INS7RUCTIONS: �� � �
Form Aed with:'
To be filed in person w 6y maii witA the CounryAuditw or Counry Recorder of the counry where the property is bcated.
Filing Dates: 1) Real Pmperty: Must file durirg the yearlor which the deduction is sought. � Counry Auditor
2) Mo6de /ManufaGured Homes rrot assessed as Real Property Must hle during the IweNe (72) monfhs ��CS/'"j„
��� CounfJ'Recorder
beto2 March 31 of each year the deduclion is sought �
GIpC . �11�11�1V N9
See reverse side 7m additional inshirctions and qualifications. .. °" '"' '
iM0�Ka7(ownerorcontractbuyu-seeretrictiovrsm�wrseside) • // . _ l • .
T ' Distriri Keyrxan6er�
a� -
As�ud vahc I praPertl' of M
March 1. anen �ear N
tl no, what s hi5 / hu eraG share ol inte�e5t?
I7 name m remrE is tliRem�t Nan fhat o( app6�nt,
Name ol rtrortgagee a oonvad se4er �
Pddress ot �r� w mnbaa seAer (num6P,r e
Name ot assi�nee or othr! awner rn
di�ant am poperty in any oNer
Inaana? ❑ Yes
DeducEan app�wi.x1 vl Ihe am0unl
Zo_ i �
Sig�ture of CotmN Autlitar
ewipUpn � Remrtl number Page numbef
-,310 -/O/ - 000. a l0.3- O e�/ 00 7 Co
:/ Contraa indebtedness unpaid as of Mortgage I Con�aC intleMetlness unpaiE as d is Ihe appliwit the sole
wrtent ynar tlate of appGc'ation legal «epuilaNe oxnM
ao 000 ❑Y� ❑ No
tF wmed vrith someone othar Ihan spouse. iMimte with whom
InOZate below
A
��«:��.
rtprtgage
stdte, and LP mtle)
�r yes. what ca,ntY' what :
No
COUNTY AUDR�
� , Zo _
Caunry
I I We certify und�the penatty of perjur�Nhat ihe above and (oregoing infortnation is
owner I contrad huyer of the aforeme`rtioned property on date application is filed.
of
and Z1P ootle)
IC 61.142-07
Mdress of auUUr¢Ed person (num0era�d sneeG rn1: �+e.
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Is Me p�operty in QuesUm: MnuaDy Pssessed
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