HomeMy WebLinkAboutMortgage_Davis (8)^'�+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
� FOR DEDUCTION FROM ASSESSED VALUATION T
Sfa[e Fam C3709 (R71 / 6-09) � � �
�,�,� Presaibed by Departmen� of Lnml Govemmenl Fnance
File Mark
� INSTRUCTIONS:
b 6e h7ed in FOR^ fl� �:
person w by mail witlr !he CowtyAuditor or Counry Recorde� o/ the county whem �r�i i�l�ied.
Filirg Dates: 1J Real Pmperty: Must file dunng the year for which the deduc6on is soughL Counry Audimr
2) Mobi/e / ManWactured Homes not assessed as Real Property: Must fi/e dunng tt3e'(waA; t�}�m` `o�nths
6efore March 31 o/each year the deduclion is sought �f� V County Recorder
See reverse side !or additional instnxGons and qualrfications. . G � �
Appfuant(owrer buye�-seeresatqfiqrysyqreverjes�g�1 _ \ � . ,..,
MarM 1. ficrrlrt yrar v
I( m. what is his / her e�d share af infrlest?
tl �wne m recntl a E'ifrerent U�an Nat ol appl
Delmr
i -a-vo -bvS- oo3-oa � o /d 3� �
febtedness unpaM az o( Mortgage / Contraa i`MebteOness unpaid as d Is ihe epplifant the sde
O OT tlate ot avP�� � a equimWe owr�(+
U ❑ Yes ❑ No
If owned with someone other �han spouse, indicate wflh whom
Is tlie DroOertY in VuesSon: MnuaOyASSessed
.-. � ❑ Rea� Roaenr ❑ amualNassessed . . _
Name of rtnrtgagre or mntracl seller �/ 1/'�
��r
ACdRSS of mortgagce w contract seDer (number aM stree4 �rtY. s+a+e. aM i
Name of assigncre w ofher ovmer or halder of rtprtgage
AdCress of assgnee (number eid streeL �y. s�ate, aM LP cotle)
Does epplimnt own pmcertY in any oNer If 7RS. what county.�
munrymindiana? ❑ ❑ -.
L+
�
�
Yes _ No
— — _
D��,���,� �o.. aol.a.......
� 1� ...
Card 1O'� a(��p.o°�.
d"�
__ ��e penatry of perjury Nat e above aM @
� I wntract buyer ot ihe aforementloned property on date
auNOrired by dWy executed Power of Aitorriey or by IC 61.1-12-0.7
> of authoraed person (number aM sheet, dry. state, anC LP code)
20
What Taprg DisUict7
20
Has Ihis deductic
for a'rent yea(.�
20 _
sle0 an P�W�Y
Yes ❑ No
2(1 _
— � �� . �Ji'��4-0�� �,�,m,. e�y r��
infortnaGOn is W e and mrteG arM that the applinnl is a resident of Indiana arW
ion is filed.
Date (monfi, day, yva�