HomeMy WebLinkAboutMortgage_Heldt'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
r_ � FOR DEDUCTION FROM ASSESSED VALUATION
� Sta[e Fortn 43709 (R17 / 6-09) �"1 � � �
� � Presaibetl by Oeparimenl ol L.oral Govemmenl Frence p�
w Jl File Mark
S7RUCTlONS:
Farm f�ed with:
�0 6e filed in person or 6y mail wifh the CounryAuditw or Counry Recorder o1 the ��n�%wj�ere /�� p�operty is located.
Fding Dates: 7) Real Property: M�st file dunrg fhe year /or which the deduction is�sb�§h(� Counry Audimr
2) Mob�7e / ManufaUU2d Homes not assesced as Real Properly: Mus( fife duringl6e hveNe (12) monfhs
betore Mamh 31 oI each year the deduction is sougAt L� ���' �""��-"'� Counry Recordu
See reverse side�ditbnal insUUCtions arM quali�x:atrons. � Vi���h
App6ram( ormnva bN'?r-seeresviraoru�n ver�ide) �_ Tf�JffCGOO'd�YncF��
nssessed vaWe d real plopaty as ot
MaRh 1. arrenl ye.ar
no. what a ha / her esa�Y share ol interesR
name m remrd "s dtferent than Mat oi a0p�nf, uWicate bebw:
r.::r,�i
Address ot rtiortgage� or mntraa se➢er (numher arrl stree{ crty,
Name of assignee or other owner w hdder of mmgage
asvgnee (number antl sfree4 clry, sfate, aM ZIP code)
property in any ONer
munry in IMFana?
. I�� I
PaAe�y�
CJ..7
Mortgage / Contrac[ inEe6tednes5 unpaid az of is Ne appi'rcant ihe sale
date of apP�� . legal or epuRade owne(.�
sammne
VJhal TaAng D'SIrir1?
Yes L J No
spouse.
15Ihe ProPMY in Vuestion: MmuDYAss¢ssed
i� Re� a�ocenr ❑ r,�uanr as�
nweue r�e nc ��.
Nas �his Cedudion been 2GUesleE m P�OeM1Y
for artent yeal+ � �
GOUNTYAUDROR
Drlfurnrn apprme,d in tlre amount af:
20 20 _ 20 20 _ 20 20 _ 20 _
Signature U Coun Caunry Date (month. daY, yea�
I/ We certify u�er ihe penalty of perjury tt�at the a ve aM foregoing i tlon is true and correc[ arW Nat the apD���nt is a resideni of Indiana arW
owner / mnVact buyer of 1he aforemenlioned property on date applica � �s filed.
' natu e/s fiAre ) Date (monN. daY. Yea�)
� —�' ��
I d app�xant(numDe/enESbeet�!state,andZlPOOde)
o�v NQr�S SN �/76rf
au by ury eaewreE Po«er W AttorneY a M IC 6t_1-12-0.7 Date (rtanN. day, yea�
P4Ere55 of airthorrzetl persan (numDer antl sfreet. c4y. sfafe. antl ZIP wde)