HomeMy WebLinkAboutMortgage_Luttrull"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
:r—
s FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09)
�' � Presaibed by OePartmeM o( Laml Govemment Rnarce
INSTRUCTIONS:
To be filed in person w by maii wifh the CountyAuditof or Counry Recorder of the county wFiere the properry is located.
FiFrg Dates: 1) Real Pmperty Mus7 file during the year for which the deducGon is sought.
2) Mobde /Manufactured hbmes not assessed as Real PmpeRy Must file dunng the hveNe (72) months
6efore March 37 of each year the deduclion is sought.
See reverse side (or addifional insVUCtions and qualifications.
I MP�n� (oxDefiEr contract 4�Ye� - see re.9+fUio791�n reverse siYR) r�. n�i
�- .-a_ = .oS- a _6b
Assessal ralue U real poperty az d Mortgage / Contraa intlebtedness unpaid as o( Mwtgage / Contract indebtedness unpaid as of is the avp�t Ue sde
Me�U 1, qs�ent year MarCh , tU nt ynar Eate of appGta�im legal w epuitaWe ame(.+
�� ❑ Yes ❑ No
If ro, what Is his I her e�ct share of inirmt? If owned wiih someone other Ihan spouse, iMirare wNh whom
If name on record's CMerent ihan Nat o1 appOnnt, intlinte helow. Is Me property in puestim: Mnuely AssesseA
. ❑ Real P'operty ❑ Mnually Assessed . . .
Nama of mwigagee m m�tract
rtiortgaqce a contract
wmer or hdder N mortgage
PDdrBSS al a55gnea (num0er aro stree4 �uY, s+e+e, anc
Does epdiont ovm property in any other '
cauntymindiana? ❑ Yes
❑ No
DeCuc�on aGWO� In Ne amount of:
20 _ 2(1�
SigfaOne W Camb A�Wimr
ciry. state, arM Z/P code)
Dra�rer \'O...ab� )
Card NO. ..SLP.�.P.�..........
� 3�� �ao. �
20 20 _� _ � 2b
Counry
stee m v��Y
Yes ❑ No
�_
Da�e (rrmlh. daY Yee�
ri� ��
I I We certfy under �he penalry o( perjury that the above and foregoing infortnation is W e and cortect and Nat Ne appiicant is a resident of Indana aM
owner / contracl buyer of the a(orementioned property on date applicalion is filed.
(oxx�e/shArertre) � -` Date(monfi.deY.Y��
—W,a� 4J' v.l`^"".V1
tl Cent eEtl'¢s of appfiwnt (number arM sLee4 �: state, and Z!P mde) �"�
a o, . e_ m �-i- �w�..,.,� ,-�-a. H
aufhomed by Ouiy eseaiteC Powr! of Atfort�ey or by IC 67.1-12-0.7 Date (monfh. day, yae�
person (number aM sbeet, rity, state,