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""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
•._—
: FOR DEDUCTION FROM ASSESSED VALUATION
• Sta[e Fwm 43709 (R71 / 6-09)
,• ! Presaibed M DepartmerY of Lod Govemmerp Ffumx
1
INSTRUC710NS:
To be filed in person or by mail with fhe CountyAuditor or Counry Recorder of tAe county where the pmperty is located. A
Fii'mg Dates: 7) Real Property: Must file dunrg Ne year for which the deductlon is sought.
2) Mobde / Manufactured Homes not assessed as Real Property Must file during the twelve (12) rtwnths C
6efore March 31 of each year the deduclion is sa�ght.
See �eversa side (or addilional insfniclions and qualifications.
Ao t foxvre� ar aon7raC 6uver- see restricbdw m reverse sidel �
Counry Auditor
ChunN Recorder
, ' � ��� d tl�D� — � � v � 7 � � � � V bg Page nurtiMi �
qoperty az ot MMpage / ContraG'viCebtedness unpaid as W Mrxtgage I Con�aU uMebtedness unpaid as d Is Ne appGrant the sole
Mart3i 1, rre.n ymr datc ot appfi�inn tegal «em,rtade or,�en
�� oo� ❑Y� ❑No
It ra, what is his / her e�t
mwtpagee or mntract seller
.�a� m � «�� ��
Name W esti9�ee w ot�er owner m
mortgage
rdy. smte. arN LP oode)
somearie other
'WU"li
IS Meyro periy in Guestian: Mmia9Y ASe55e0
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�i?�!� � JO N l� IZ '(K.11 Si
3A�r�nrl.� s �usi'
MEresso(assgnee m0erarMStree4mY.stafe.entlZlPmCe) at�`O�.l`(�lJ l
1�T 1 -io 93�80 R �.
Dces appizaM ovm Woperty in any dher I( yes. M�at count�? Wl�al Ta�dng DistriC9
munry in Ind'ana? ❑ Yes ❑ No I iw airtem Yea!? ❑ Yes I
❑ No