HomeMy WebLinkAboutMortgage_Wolf��
� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
• State Fwm 43709 (R11 / 6-09)
�' � PresviOeE by Departmenl of Local Governnient France
Fil
INSTRUCTIONS:
To be filed in person w by mail with the CountyAudito� o� Counry Recorder o! the counry where the property is located.
F�"'��' 2 S 7009
Filing Dates: 7) Real Property: Must file dunng the yearlor which the deduction is sought. Counry Auaimr
2J Mobile / Manufactured Homes not assessed as Real Property: Must file d�nng the tweNe (12) monfhs
before Ma�ch 31 of each year the deduction is sought County Recorder
� 4 .�ff
See reverse side !or adtlitionel in;trucLbns and qualificatrons. ..
Assessed vapm d re� p�opttty as d
M11&th 1, amnl year
�
I(110. W�12� {5 �16I �IEf BXdf15�Idf8 Oi YI}ClPSl7
It name m remN e dAferent Nan Nat of appl
Name W mvtgagee or wntract setler
Pddress of martaaaee w mntrad sWer (nun
legal
—/O � ��v.
2a inde6tedness unpaiE az of
and strae4 �+N. stafe. aM LP cade)
Name ot azsignea or oNer owner rn halder W mortgage
Aderass ot auignee (numbe� and svee4 �Y. yefe, am
Does eppfuam ovm property in any oNu
�,ruy � i�e�a ❑ ves
❑ No
Deducfiu� app�wed'u� Ihe aT0un1 of:
0
Sig�Aae d CaunN AuEimr
' O
SOIIIPdI12
Page
legal w eduitable ownM
Yes ❑ No
wiN whom
IS 111E pfOPCIIY N QUC5110I1: iU1flUdq' �
�RealPmPenY ❑�Y�
Dra���er 10....�;DO.n7,.,...
yes. what muntyT NRat Ta I 1 ���
�O�Y
• Card NO. ... `i ............... ❑ No
couNnnuorroi � l�j�l,lebO.Ol� --
2p — � 20 — I 20 I 20 I 20 I 20
Date (month, daY. Y��
1 I We cer4fy uMer ihe penalry of perjury that the above and faregoing infortnalion is We and cortect arW that ihe appticant is a resident of IMiana aM
owner I contract buyer of the aforemeMioned property on date appliration is filed.
i�turelo hAnamel Date (rtmtl; daY.lea�
riry, state,
Person auuw�treC by EWY ezeaitea
person (number arM street ciN. sfafa. a�N LP wtle)
Y��