HomeMy WebLinkAboutMortgage_Scraper"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ .= FOR DEDUCTION FROM ASSESSED VALUATION
State Form G3709IR71 / 6-09)
� � Presaibed by Depertrt�eN of Laal GovemmeM Firwce -
� Fi
INSTRUCTIONS: F� �
To be filed in person w by mail with the CountyAUditor w Counry Recorder of the county whe2 the properry is located. �
Filing Dates: 1) Real Property: Mus! file dunrg the yrearlor which Ne deduction is sought. A R Couu' O quditor
2) Mo6�7e / Manulac[uled Homes not asseued as Real Ploperty. Must file dunrrg the M1velve (72J months
befae March 31 0/ each yea� the deduction is sayht ❑ Cou^ry Recordu
See reverse siCe (or add"rtionef instructfons and qualifications.
npp�am r cont�aebuyer-s� mre �side) n � q _ OIBSON COUNTY AUDITO
i ralue oF real PmPenY az
a�rt KN
no, what
nane m
b a3 -� a num0er O Page number
ui�ct trMebteCness unpzM as Is Ne appfrcanl Me sole
3tim legal or epuitade mme/7
n Y� � No
esn n�a �m �,�e �m�, m�, sw�e. mc�u �n„�„
aGGOtlnt. hNicate Eelmr. Is Ihe praperty in GuesSm: Mm�aM Asscssed
❑ Real Proaem� ❑ Mn�a�r Asses�
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Name ot � «canrra�s sener
aaeress or � a m,o-� �m•. �-.-•----' -•— -
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SA�Dkf} �
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Deduaion appro.�ed In Me amoum
20 � 20
ro>
rhal count�t 4Mat Tadn
- couNn nuorroR
20 20
Has Iha dedu�SOn Deen reGUnsted m 7�Y
rrn cu�� y�n n.,_ _ r-i
2p _ I 20 I 20
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under th nalry ot perjury at Ne above and foregoing infomialion is true and corte�3 arM Nat Ne applirant is a resident of Indiana aM
act buye f Ne afomme ' property on date applintion is filed.
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lent aEd`ess of appfrent (numDer antl sLeet sbte, entl LP oo�
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iu0w'vedEydWyes cetlPv+rtolAttcmeY�MICG1.t-12-0.7
af author'¢ed person (numGer arM sboet �'. s�te. an0 Z!P code)
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