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HomeMy WebLinkAboutMortgage_Anthony'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year FOR DEDUCTION FROM ASSESSED VALUATION � ? . Stata Form 43709 (R71 / 6-09) � �` Presaibed by DepaRrtierR af lnral Govemme�LL Fi`arrx "" T � File INSTRUCTIONS: � b be fited in person w by mail with the County Audito( or Counry Recorder of the counry wheie the property is ted. � �� Fitirg Dates: i) Real Property: Must file dunig Ne year (or which the deduction is sought e—t''unty Auditor 2) MobAe / Manuladured Homes rrot assessed as Real Pmperty Must file dunng the hveNe (12) months O C O� L(�1Drty Recorder 6efore March 37 0( each year the deduclion rs sought. See reverse side 7 ad tional insmictions an�al'dicafions. n ` Key Ma�U 1, nnpnt year rc �w, wnat a na � trer exaG share or Inin,rest? �'�-l�x�a�-�o as,�-oaa. 9e/ a'v+CeMeE Paid as W Contar3 i MM�artd�i 1, wrtent yeer da ficatim If name m remrC is dAterrnt than Mat a( appOCant, v�ak Name of nwrtgagea or mntraQ seller Address of rtnrtqagee or conUatl setler (number and sb Name o( asvgnee w othr! owner or halder of rtartgage AdE2ss of a.ssignae (number arcl street �S: s+ete, an' Does appkant o.m munty In IMena? � ypperty in any oNe� ❑ Yes ❑ No in ihe amount of. � N ' � W Camb nuditor ffi�, _ _ ao�o ..... Dra\�'el- NO.... - — � ��5. . ...... _ c:�t-a �o. ... ..� :. .. . �a0, � 2U I 20— � Counry � spouse. mdi�te Is U�e property in Questian: Mnw � Real PfoPertY ❑ Afmual Alodle Fias iha dedutYion 6een far Wt1Ent yP2(� � �Y. Y�A ritaNe owneR Yes ❑ No � P�Y ❑ No �_ .� I I We certify under the penalty ot perjury that the above and foregoing infortnation is true and mrtect and that Me applinnt is a resident of Indiana arW owner I contract buyer of the aforementioned property un date application is filed. VJ / rslutl nal X�il�1l y/ A Date imonfh, deY Yga� .. i�� mh�/l� r I�� ot autha'ved persa� (number aM sbee; dly, state, anE LP mde)