HomeMy WebLinkAboutMortgage_Trotter—^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
, : FOR DEDUCTION FROM ASSESSED VALUATION
- � State fotm G3709 (R71 / 6-09)
�,,,� 1 Preuribed by DepartmeM of Wcal Govemmenl Firence
�STRUCTIONS:
To 6e filed in person w by mail with the CountyAuditw or Counry Recorder of the oounry where the property is located.
Filirrg Dates: 1) Real Properry: Must file dunng the year /or whicA fhe deduction is sought.
2J Mo6de / Manufactured Homes not assessed az Real Property Must fi7e during the IweNe (12) monfhs
- before March 37 of each year the deduction is sought.
See reverse side fw additional instructions and qualilcations.
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Name of rtxrtgagee w conbad seller � I
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AAdres of �mtga9ce or mntrsd seAer (nimber and sbee4 uN. sta�e. aM LP code)
Name of assigriea or other owner or hdder of rtwtgage '"
O�1c8��Yd�m.
(�inty Recorder
COUNTY
ffi
: ot apqKatqn regai or epurtade owrer!
❑ Yes ❑ No
sameorre aher �han sPW�. indipta witli wtnm
Is tM proprlty in Qu�bon: MnuaOY Assessed
❑ Rea� PropeAV ❑ ArmuaM Assessed
AdCress of assgnee (num6eraid slree4 �1: �..{�./I I- y i a 7
O�
Dces appllpnt wm poperty �n any omer
munry in IrWi3na?
❑ Yes
Deduclion apyweC in Ne amounl aF.
�xa,,-,� S. J� jog�I'7 � , -
r.1� _
5(3.��e�' .�- _
I
Nas �his deduction Eeen repuescetl m piopeity
tar wrren� yeaR
n Yrs ❑ No
2p 20 20 20 20 2(1 20 _
Signature of CounN AWitw Counry Date (rtpn(h. tlay. l'�aA
I/ We cerbfy under ihe penalry o( perjury that Ne above and foregoing mfortna�on is true and correc[ and that Ne applicant is a resident of Irdiana aM
owner I contrad buyer of Ne aforementioned properry on dace appfica0on is filetl.
street
) r� I�..��� j�IA��SfI��Q iN
fuNexewc�e'aowe' r�f°nuomerorhy�c .t-tz-0.7
person (number aM Sbee; ri(y, slale. and LP rnae)
Date (marth. tlaY• ige�