HomeMy WebLinkAboutMortgage_Henry (2)'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__,_ ; FOR DEDUCTION FROM ASSESSED VALUATION
. . � Sqte Fwm 43709 (R71 / 6-09)
S ur � Presmbed by DepartmeN of lnml GovemmeN Firence
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INSTRUCT10N5: /�I'
To be filed in person w by mail with the Counry Auditw or Counry Rewrder ol Ne counry where tAe properry is loca(�ed' � 1 /��
Fd'mg Dates: 7) Real Propeity: Must file durirg the year /or which the deduction is soughL ��� County Auditor
2J Mo6Re / Manufactured Homes rrot assessed as Real Property Must file dunng the twelve (12) months
behre March 37 of each year the deduction is sought. �6,,,, %,�, Counry Recortler
Seeieversesidelorad�itforl�linsVUClionsandqualificatrons.�� / C;�RSnN f:n11NTV AIIDITOR
I AoP��t ( _ - see r�sMrlions m re0E7ae sid}) . r� _ .
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nrre�rt yPar
�( M. W�18� 6 �IIS � i1M ExJC� 5�12f9 O�
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1f name on n,md is dirte�ent Nan fhat ot appOwq LMkate bebw
Nartre ot mortgagee or mntract seDer
nmtgag� or mntraG seAer (numbrl arM stree4
morigage
S7ate, aM LP catle)
�
date
legal or
Yes U No
If owned wiM someone other chan spouse. Indimte wah wlwm
Is ihe property in Question: MnuaAy Assessetl
❑ Real Pmpero ❑ armua�Naaes�
Dces applimnt own yoperty in any oNer If yes. what muntyt What Tapeg D'Stri[17 Has Nis tleCUUim Deen 2puesteO on proprity
munry in Inaa�u? ❑ Yes ❑ No tor cu(rent yeaR ❑ Yes
❑ No