HomeMy WebLinkAboutMortgage_Brown (2)� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun�
_. FOR DEDUCTION FROM ASSESSED VALUATION
• State Fam 03709 (R71 I 6-09)
�' PresbibeC by �epartmenl of Lo�l Govemmenl Firence
w.
INSTRUCTIONS:
To be fiied in person w by mail with the County Auditor or Counry Rewrder o( the oo�nty wHere the properry is located.
FiNrg Dates: 1) Real Property: Must fde dunng Ne yrear for which Ihe deduction is sought.
2) Mo6i7e / Manufadured Homes rrot assessed as Real Property: Must file dunng the (wefve (12) rtwn[hs
before March 37 0) each ye�t(he Ceduciion is sought.
See 2verse
Tari Di /�.(N v`' Key rvanCer / legal tl�
Asess� vahm d reai pfapr�ty aa of Mortpat ef
MM31 7. G12nt yqr MBrd�
tl no. wha� Lc hi5 / hu eYatl shaR 0( ult¢lMt?
If name m 2mN b E'ifterenl tlun Ihat W appOCanf, IMirate
Name of rtnrtgagee ar mnVact seuer // /�
1
Addr� of nartga9ce or cantraa se�er (n'mDer sn
Name at assignee w dhrl owntt or halder af rtartgage
Aderass af assignee (numC ��^ stree4 �y, slete, and
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Dces t
iCou/nItyI7AuditOr
a:o�iy �emrder
��i—/o2—��'DOa. lO(o-D/$ ���.'Ir� �°"°' /D
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IMebtedness unVaid as U �ong� eaP�� uWebtedness unfmid as of �� M���e wme(1
POO ❑ ves ❑ No
tf ax�red with swneorie dhel Man sP��. indkate with M�wn
arN LP mde)
ePDLtan OwnV�De ^ - _ � I..•
munry in Indiana? .. f�� .
i�
zo
I / We cer[Xy urWer
owner I contraG bu
Ta�drg DistriU7
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�� �P �-�,on '�. �� �R
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�d
autt�atrea EY diM ezewteC
s ot aW�a'ved pasm (num
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Is Cie property in QuesDm: AmwaOy AssesseE
❑ rxe� a�ove�' ❑ rv�uaq'wssessea
a�oeae rro� nc 6�.
Has Ns deCuction Deen re9uestr� m piope�ty
ror anrern yran r� .. r�
zo_ zo_
I unry _�t../ /(i7_^_� Datefmonth ay,/—�O
j v K ��V/
of pe Nat ihe above and foregoing infomialion is We and mrrect arM Nat the applinnt is a resident of Irnliana aM
oreme tioned property on date appiication is filed.
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