HomeMy WebLinkAboutMortgage_Bonney"�+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hip Year
= FOR DEDUCTION FROM ASSESSED VALUATION
Y • Stace Form 43709 (R77 ! 6O9)
S / P�e.viG¢E by Departrtient ol Local Govemmenl Flrance
°'� File Mark
�STRUCTIONS: �
F
To be filed in person w by mail vntA the County Audimr or Counry Recorde� of the wunry wheie the pioperty is located.
Fifing Dates: i) Real Property: Must �te during the yearlor which the deduc�ion is sought. ��. r
2) Mo6Be / Manulactured Homes not assessed as Real Property Must fiie dudng fhe tweNe (72) months ❑
6e(ore March 31 0( each year the deduction is srought. Coun . e� er .
See reverse side /or adUifional inshuctnons and qualificatons. G �� �
e�,�.�����„ rrmno-arlbueer-see2strcamsm2versesidel i /i _ ,. �
Ta�ung
P.ssesseE rdue d real P�P�Y � d
Martlt 1. ar�ent Ymr
no. xRat a his / her erar� share
If `wrie on
Key numher / legal Q[4¢iptirn
' ��� —°
A7ongage 1 Contraa u
Mamh 1. artent year
terest?
o( aD�j mdinte bebvr 1 '
F /I i.>�If /_
Name of maf�agee or conttaa seller /�
\S1%
Address of mortgageP «oontrad seAer (nu�
Nym¢ 01 assign¢¢ or other owner or hdder �
AdAmss of asv9nee (num0ar aM sbcet �
Ooes appliranl o+m propury in any oNer
couny in IMiana? ❑ Yes �
�
om�aw� approved m ure ama,nt oe
20 _ 20 _
j Sig�atlne d Co�mb AuEitor
— ��Q • Q
if ovmad wifh
� ar�Str�4 uN. sfa� aMZIP mCe) �
/ /
iort ge
art
ate, ard ZIP ootle)
If yes. what munl/? Wha1 Tadr
No
COUNTYAUDROR
20 � 20
Caunry
20
Remrd numbu
' Q�� � � �
traU udehtedness unpaid es of I
p� I
O
�her n spouse. iMicate wtth who
�ilable owner
Yes ❑ No
propn�ty m Vuesbm: Annua�Y Asesud
eal Pfopefly Q Armua�ly Asessed
MoMle Har�e (IC 6
�
Dra�ver \O.� • � •......
Card NO. .. ��...........
�13,000.°��
I I We certify under the penalry of perjury Nat ihe above and foregoing information is true and cortea arW that the applipnl is a resident of Indiara aM
owner I contracl buyer of �he afwementloned property on date application is filed. -
� .ay�w o..,,o, .. .o
� WI vtlent adNess W appfx
3o E.
Pelson auNOr¢ed by Eidy es�
Mtlress oi autlwaed person
t��Sv,��ld 1�
by IC 6L742-0 7
aM stree; tlry: stafe,
IDate (nionfh. day. yee�
y 7 �665- 0007
Date (monfh, daY• Ma�