HomeMy WebLinkAboutMortgage_Duff^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun To Year
_ � FOR DEDUCTION FROM ASSESSED VALUATION
- � State Fwm 43709 (Ri t/ 6-09)
-� PrPSaibed by DeOartment of Loml Gavemment Firance
File M���
�STRUCTIONS:
To be fi(ed in person a by mail with the CountyAuditor or Counry Recorder of Ne wunry where the pioperty is located.
Fd'mg Dates: i) Real Pmperty: Must file during the year for whicA the deduction is sought.
2) Mobde / Manufactured Homes rat assessed as Real Property Must file dunng [he lweNe (12J months
6efore March 37 ot each year the deduction is sought.
See reverse side !or addrtmnal instmctions and qualifications.
APP�m��iawne(\ oJr�m(�ntr�CtbN'E(.r�-see�_'s�q����s m2
_ 7 1 1 �L�AIn 0 .1 `l � �lzll
Ase�eO rehie af rral praper:y
Mart�h 7. Mr1rt lear
If �m. what R hs / Mf e�act
It narne m
of mort9agee w canbaG
r� o� u�g�� ««ne� ow��r
own poperty in any aher
ia? ❑ yes
the amount
20 _ � 20
ot Counry Auditor
vw�
trid'uate oeb�r.
strxeL uN. sram. aro ur rooe�
�; ��e, a,a �,r ��
�
�unty uditor
7 ""
❑ Coun q�r
.,tv P
r4unbu
Mongage I Cantrut uMehteCrress �mpaiC as d is tne epp�am me sae
dale of aOP�� �� a�bbie amer+
❑ Yes ❑ No
wiM someo�re oiher ttan spouse. iMicate wiM whom
Is IM property in QueStion: M�ueDy Assessed
� . (�RealFhopertY ❑M�ohle�Home�flC��61.1-i
Vfiat Tariig D's
20 _ � 20
aoia
Dra���er NO ...................
Cai•d NO. ...��DDa-.........
2(I _ � 20
Dale (monlh. JaY,
i I We certity under the penalry oi perjury ihat Ne above and foregoing infortnation is We and wrrecl arM that ihe applirant is a resident of IrMiana aM
owner I conVad buyer of Ihe afoiementioned pro0erty on date applicadon is filed.
..,�n�.e r.,,.,..erc r,nm,�,.�a _ Date (monfi. deY• 1'aa�)
FWI revdeni adCress of
�n a�
city, sfate,
�'
person (number arM sUeet �ry, sfa(e, aM ZIP oode)
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