HomeMy WebLinkAboutMortgage_Chandler"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__, FOR DEDUCTION FROM ASSESSED VALUATION
� State Form 43709 (R77 / 6-09)
S J Presvibetl by Oepartmerd af Loml Gwemment F� '
� de ark
INSTRUCTIONS:
To be filed in person or by mail with fhe CountyAudiror or County Remrder o( Ne county whe2 the pioperty is locafed. F � � Z�Q 9
Fifing Dates: 1) Real Pmperty: Must file during the yrear (or which the deduction is sougAG � Counry Auditnr
2) Mo6ile / Manufactured Homes irot essessed as Real Pioperty: Must file dunng the hvelve (72) months
before March 37 0l each year the deduction is sought. �' �0��°�d�
See reverse side for additional inshvctions arM quali�cafions.
Ma�M (mA+�eror�no-yd euyer- see ms�c�lqns on rerorse si�4� n
AseseEvdueofmalPmP tYaSOt
Memh 1. aY�e�rt year
n no. wha� s na � ner exaa snare or interesc?
If name on �emrE
mntracl seller
r/ legal des6ipn3fi Reco�d nu Page numb�
(�-o�- '1 �l - ba�l�bc O� i
Mpr(p�ge I ContraG'udehtedn�s unpaid az of Mortgage I Contract indebied�ress unpaid as of Is Ne eppl'rcant Me sole
Marr3i 1, a t yeer Eate o( appGCation . legal wgw itahle awneR
� l �� r�r�T I�'rr� ❑ No
se0er (number end sbee; rAy, stam, aM LP code)
Name of assignee w oCrer owner w Imlder of matgaga
Address of assgnce (numOer aM streef, ary, sfete,
epplimnt Ovm prope�n any oNer r
y in Indiana?
�� l
mon appfoved 4� Ne amount aE
20 20
ihrte N CounN Auditur
If yes. what munty?
No
COU.
20 20
SpWSe,
Is O�e propertY in 0��: MnueDy hssesseC
�kea� a'openv ❑ ivmi�aM osse�ed
_ -- - -1 � p �o r,E7�--
_ ��Q2Y
_ 0��3J�1 �
What Tad(g D'¢i
�
t
�
2l1 _ 20 _
Oate (rtmfh, daY• l�e�
I/ We certify under ihe penalry of perjury Ihat Ne above arid foregoing infortnation is We and mrtect and that the applirant is a resident of IrWiana arM
owner I mntract buyer of Ne a(oremerrtioned property on�te applicatbn is filed.
FW re4tlent address [
! o �.
Person autho�aeA Gy �
61.
person (number arM sbee4 �+ry. sfa(e. and LP
L�� S� �f Z G G
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