HomeMy WebLinkAboutMortgage_Townsend"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ , FOR DEDUCTION FROM ASSESSED VALUATION
. . �� State Fortn 43709 (R71 / 609) ��\O
,' w. � Presrribed Ey Departmerd of Loml Gavemmerit Firwce �
' File Mark
wsrRUCnoNS: \Q
To be filed in person or 6y mail with the CountyAUditw or Counry Recorder of the counry where the pmperty is locafed. F� �� ��
Fi(ing Dates: i) Real PropeRy: Musf file dunng the year fir which fhe deductan is soughL � Cqunty Auditor
2) Mo6Ae / Manufauuled Homes not assessed es Real Property Must hle dunng the tweHe (12) rtronths
before March 31 01 each year the deduction is sought. ❑ County Recordu
See reverse side for addifional insVUCUons arM qualilications.
(owner«ah7aa r- mrerorseside)
►�° �o� 0 50�
7ap�g �' ' Key rnanp¢r / al Q_� bon _ OD ���_ O � Remd numEei Pa9e nun. bri
` � '� O
As�ssssed vaNe d real property as of Abrtpag e�/� �Contraa inde6ted�s unpaid as d Mortgage / ContraG ifWebtedness unpaitl as d Is Ne ePP��nt the sde
Me�ch 1. aareN year Mart3i�d�'�" t yeq� /� dale of appficatim legal w epuiHWe ow�re(.�
JS � 1. 75 I 1.OD n Yes ❑ No
ro. wha� Is �'s / �er erart share W intnrest? � h ownaE vAM mmeofre other than spouse.
rartie m
rlame m matgasee «cm,raa seue�
Add� of nnrtgagee w mntraa seDer (number and street �Y. 5ate.
Name of azsignee or Wrel awner or hdder of nKVtgage
ACtlress oi assignee (num6er aM svee4
E
Is ihe O�OenY in GuesOrn: MnuePf AssesseE
❑ Real PfoPertY � ��Y�
eno� � nc s
yopeM1y in any oNer I II yes. what wunt�? I NRmt Tarirg Distriq7 I Has Nis deEUClim Deen O �m pioprJly
for currem Yea/? ❑ I
n Yes ❑ No
COUNTYAUDROR
DeducOOn app�oved in tlm amount oE
20 _ 2b _ 20 20 20 _ 20 _ 20
$i9na4rte d Camry /wtlitor Caunry Dete (monfh. daY. Y��
I We certify unAer Ne penalty of perjury Nat Ihe above and foregoing intortnatlon is true and correct arW that ihe applicant is a resitlent of Iridana a�
er I mntract buyer of the aforementioned property on date application is filed.
name Date (rtmtli. daY. Y��)
of app(nani numDer antl 4�: end ZI e) ��
Pae.m aufAw�.d Cy dWy esecuted Power o(ACmmay w by IC 67.1-12-0.7 Date (mw+fh. day. yea�
AOdress of auttm'trr� D�"� (numberaM sbee4 �Y. uata. an0 Z!P cntle) .