HomeMy WebLinkAboutMortgage_Light"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ . FOR DEDUCTION FROM ASSESSED VALUATION
- • State Form 43709 (R71 / 609) �
•�' ,,,, Presrnbed by Departmerd af Laal GovemrrcN Firence �–' O' �
File Mark
�STRUCTIONS:
To 6e (led in rson w b mad with fhe Coun Auditw or Coun Recorder o/ the coun where the F� p� ��
Pe Y b 4' N P�PertY is located.
Filirg Da[es: 7) Real P�perty Mus[ file dumg fhe yrear for which tha deduclion is sought. � �unty Audiwr
2J Mo6de / Manu/actured Homes rrot assessed as Real Prt�peRy Must fiie dunng the fweHe (12) months
6e7ore MafcA 31 of each year the deduction is srought. ❑ County Recorder
See reverse side for addiUOnal instructions and qualfipti�ons.
Aoofil�t(o�vre�mmnU'aGbuYer-seeresbroWnsmreversesdel /1' _ '
Key rnirnimber / legal tlesaiption V RemrC number Page num6er
Q.�.� a _`�a�t- 000. 6dS-�d �!l K��°
i� pfoperty az W Mwtgage / Contraci uWebtetlness unPaia as W Mort9� / Con�aC hWebtedness unG� as d k tlie aVPfi�t tlu sde
year Mard� 1, curtem year date of applicalim legal or equitade om�e/1
4� �3 � nY� ❑No
If �ume an recwC is Sdferent Ihan Nat of appliw�l i�Mibta Eebrr.
W rtiortgagee ar contrad seller
Address of mut9a9ee w contracf
Name af assignee w W� avmer
I 1 J l� 7/— I^
Oces aPWipnt own property in anY oNer
munry in Ind�ana? ❑ Ye5
DeEuction approveE in Ne
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and sLeel, ciry, stafi, an0 ZIP code)
ate, andl ZIP code) C
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u res. wnat cwop?
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VYhat Tanrg D�stritl?
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Is the property m Qursron: Mnua�y Ps:rsstd
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Dra�ver N ...........
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Card NO.�..•-�'�;�,3�: �..
�� aeaumon Deen requestetl m pmprlty
Ifw tument Y� r-t ._ r-i
20 � 2i1
I/ We certify under the penalry oi p�rjGry that the aho and foregoing infwmaUOn is We and cortect arM ihat the applicant Ls a resident o( Indiaria aM
owner I mntract buyer of Ne aforef(entloned pro on date applicatlon is filed.
�reW ownaYS hdnzme) Date (rtiorvh. daY• Ya�)
II resident aEtlres of a mant umbsr aM , dry, s7ate, and ZIP cotle)
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rson auUni¢Ed �y tluty esecuted Power W Y�r Cy IC G7.1-12-0.7 / Date (mon�b. tlaY. Y��
Pddress of a�Marzed person (numbera�M sbee; ciry, 5tefe. arM ZIP cade)