HomeMy WebLinkAboutMortgage_Ball (2)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun sh' ear
_, • FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R11 / 609)
\ P p��p� py pe��n� af Local Govemrtrent Fnance
�� File Mark
NSTRUCT70NS:
b be lled in person a by maii vnth the CowtyAuditw or Counry Recorder of the county where [he property is located. F� �':
filirg Dates: 1) Real Pmperty Must file durirg fhe year for which the deduction is soughG C❑j � d�
2J Mo6ile /Manufactured Homes not assessed as Real Property: Must file dunng the M1velve (12) months `
before March 31 of each year the deduction is sroughG ❑ CouMy ! er
See reversp� side !a addi(ional instrucfions arM qualificafions. G I B
�ApPrr�m—�roroontrayeYYe�'se�es�+i�ns9" .�ersesife) . n . /1 n /I
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d ralue eal p�perty a d Abr(qage / Contrati ude6tednrss unpaid as of
Marth 7, cvmit r Mamh 1, airtent year
I1 ro, what's Itis / her eraG share o( infe+esi? If awrn
11 name m re�nrd is Eiftuent than Nat ol applicarit ��te bebw:
tJarti¢ of rtrortgagee or contraG seAer [
AEdress W mortgagee a contract seller (number nd 1, ciry. state. aM ZIP oode)
Nama of assi�ee or Wrl owner or holder of mort9 ge
5
Ad4255 of asssiyiim (munDai eM 512e1, dry, sNdte, and Z/P coCe)
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nunty.� � What Ta�dng Dis�ia?
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20
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Record number � Page
as ol Is ihe
� legal�
Yes Ll No
�I5p,(� pmpertyinQuesCOn:MnuallyASSesud
IXI Reai ProGenY ❑ A"^�Y �
7l Modle Hdne (IC 6
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Has Ihis tleduGim Deen 29uesteE m propelty
ro. a,�t y�n ,—, - - ^
20
Daie (monN. daY. Y��)
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I/ We certHy under the penaliy of perjury that the above arW foregoing infortnation is We and correct arW Ihat fhe applirant is a resident o( Indiana arW
owner I contrad buyer of the aforementioned properry on date applicalion is filed.
�r s y�ac�
aulhotaetl G/ duly ezecute0
o(Attort�ey or Cy
person (num�eraM sbee; cry, state,
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