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HomeMy WebLinkAboutMortgage_Feagleyry� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year � FOR DEDUCTION FROM ASSESSED VALUATION �• State Fortn 93709 (R11/6-09) � � Presaibetl by DepartrtreM of Local Govemment Friance INSTRUCTIONS: To be ned in person or by mad with the CountyAuditor or Counry Recorder o! the wunry where fhe pioperty is lorated. FE Fl7ing Dates: i) Real Property: Must file durirg the }rearlof which the deduction is sought 2) Mobde /Manulactured Homes rrot essessed as Real PropeAy Must file durng Me hvelve (12) monfhs 6etwa March 31 of each yEar the deduction is sought. C� See reverse�ide for addrf'anal instruUbns and qualifications. Aoofra If rocmnfiacfbuwr-aeerasbirb"m reversesidel w i-.. _ ��N Key � rahia dmal AW�Y as ol 1, wmLL year Tat fs his / tcer exaG share oi interesi? rc �wne o� remra �ee or mntrati se0er mno-aa seoer =0� � N/- �D-Od 3. `75'0-0/ t.lwfpage / Contrati intl�ted�ss unpaN as N Mortgage / ConbaG ude Mart�h 1. a�rteM yeer date af appfimtnn � N awne0 vriM someone oNer Can Name a1 assignee w otMr wmer or halder ol morigage � I I WE owne (n�mber antl stree4 mY• �, aM app�wed'e� ihe amoum ot crty, state. i , S • . . Drawer NO..�� � � Card No. .... 5�y�....... oN6 ��,g933.�1. app uant � ran0 s8ee4 dN, sbte, a�u ... __ 53s9 � s90 7� o��4.y dn Y�Ll�4 Person auNOirzed Oy duly exewteC Power of Atlomey m by IC &1.1-12-0.7 Addren of aNhor¢ed person (numOareM sbee4 �y, sb�e. entl LP wtle) COUNTYAUDROR �0 20 c«m+r I -U —CbuntyAUditor 9, mty Remrder , ) Q �� as d Is ttre apP6�ant tl�e sak kgal a e�uimme o+/r�c(1 ❑ Yes ❑ No with �N�wn I�sJf�e propelty in Question: MnueDy Assesutl #J Real RoPertY ❑ Armua�I!Asse55ed 20 oace (�rn. aar. r�A �i �_ ig infomiation is we and correa aM Nat Ne applirant is a resident of IMiana ard ation is filed. �� „�,. �y,��