HomeMy WebLinkAboutMortgage_Hurst (8)^�� STATEMENT OF MORTGAGE OR CONTRACT I��y �E� un Tovmship Year
_ - FOR DEDUCTION FROM ASSESSED VALUATI � 1�
� State Fortn 43709 (R11 / 6-09)
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�STRUCTIONS:
^ Fmn t�ed wiih:
�0 6e lled in person a by mail wdh the CountyAurlitw or Counry RecoNer of the oounry�vheie a located. �
Frling Dates: 1) Real Properry: Must �e durirg Me year for whirh the deducfion is mughL ) Counry Auditor
2)Mo6de/ManufacturedHOmesrrotassessedasRealPropertyA�u��i75�+r�8��hveNe ITOR�hs ❑ CountyRecorder
6eto�e March 31 of eech year the deducfion is sought � Y A
See reverse side,far9dditior�al inshuctions a� qualificafions. ,/
Key �w al d
If name m rem�d is tlilfe�art Nan Nat ot applkant'oidicate below:
Name o( mortgagee or mntraa se0er
Address of mM)agce w
.T �i•-.-c'.a'➢
ciry, 9ate, antl ZIP cotle)
Dces appikant awn pmperty in aM � � If yes. wlwt muntyt
counryinlndena? .--.---- ..-.
� �l u2s, So�-iN � _
/�'�D�va�A �2
/i -si�3
I/ we certry y�er Ne p
amer / cont/aU buver of
Fddress of auCmr'ved Verson
of
neca�a rw ra9e numov
23 �6 �F-o /'] �
as ot Mortgage / Convad i�ebtedness unpaid as o( Is Ihe appG�ant the sde
date of apP6�tion legal w epuitaNe aw�
❑ Yes ❑ No
owned �viN somrone other tlian spasse. intlicate with �Nnm
Is Me property in Question: Mnualty Asessed
❑ Real Pmperry ❑ Nmually AssesSed
I NTaI Ta�drg Distnd? I Has
forc
)UNTYAUDROR
20 20
Counry �
20
�
m P�openY
❑ NO
20
1 � ���
Ihe above and for ng infomialion is W e and cortecl and Nat Ne applicant is a resident of IMiana antl
property on date cation is filed.
Date (rtmtli. daY Yge�)
rdstreet, afry�ys� e. and LP cad� /� yn�
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