HomeMy WebLinkAboutMortgage_Lamar"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS oun T ip Year
FOR DEDUCTION FROM ASSESSED VALUATION � �,
; T,. • State Form G3709 (ft17 / 6-09)
�,µ � Presmbed by Oepartment ol Laml GovemmerLL Frence
WSTRUCTIONS: �t� �iI�A�9
To be filed in person w by mail wifh fhe CountyAUditor or Counry RecoNer o! the counry whe2 the property is located.. F� �� ��
Filing Dates: 7) Real Pmperty: Musf file during the yrear (of which the deduction is sought. ,�J
2) Mo6�7e / Manu(actured Homes not assessed as Real Property Must fife dunng the fwelve (12J months i'( 4j� �� '//� nry Auditor
6etoreMarch37o7eachyearthedeductionissought. GI6SON UNTY AUDIIVM �
See'everse side lor adHitional insUUCtions and qualfications.
Apdcant(ownerwcontraGbuye�-5eaiesNCtionsmreversesitle) �7 _ " /
/l � _i Y !1
Tapng �istrvY • KeY �� /�9a1 desdption RemN n�mbel Page numDer
/ �� -o� -ob -�b-oDa, ob5-oi � od 9 3�oD
AsusseC rdh�e Wopeny as d A1oRqage / Contraa IrdebteEness unpaid as d Mwtgage / Con�act'vWe6tedness �mpaid a d is ihe apparant Ne sole
MarM 1. Mrnt Mart3� 1. airtem year date of appfmafion Iegal w epuitable ax+ceR
�01� ��� ❑Yes ❑No
If ro, what Is his / her exa(Y share ol interest? If owned wiN someo� oNer than spouse, irdirale with wMm
If nama m 2cotd is dMerent Nan Nat o( aPG�^l �^4�� ��' Is the pioperry in Questbn: MnuaM Assesse0
❑ Rea1 aioaeKV � �^^�N �
MoM7e Fbrtie (IC 61.7-�
Nama ot rtartgagee or mntraC se4er /�
�
AGdress of mtxtgagee w cmtracl uAer (nwriber a sn
Name ot assignee w other owner or hdder of rtartgage
AAtlress o7 assignee (num6er antl svee4 my. sbte, and
Oces epplipm own property in any aher
munry in Indiana?
❑ Yes ❑ No
Deduc6m approved In Me amount at
zo _
�reture ol Counry Aud'aor
I I We cerofy unde
owner / contract buye
�nature (ownerF hN narm
I siCenlTe��
tdy, state. ard ZIP code)
U yes. whac cmmty?
�_ � �
penalry of
ot the aFw
� W
What Taritg DistriclT
O
Has ths dedu�m Deen 29uestee m v�WP+�Y
� �� n� ❑ Yes ❑ I
D►•a�t�cr NO...� ..��...1......
20— Card NO.
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� �8 1.2C�, lna� • oZ�
Ne aDOVe arW foregoing informalion is We and mrtect and thal Me applirant is a resioem u� �� �.ana and
property on date appiiration is filed.
Oam (rtnnM, daY. Y��
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tlay, ysa�
Pdtlress of aWror'ved person (num6eraM sbee; rity, sfate, artl LPCOde) . ^ /
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