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HomeMy WebLinkAboutMortgage_Catt'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year FOR DEDUCTION FROM ASSESSED VALUATION Sfate Fortn G3709 (R71 / fi-09) , Pres�ribed Ey Departmerd of Laral GovamrtieM Firance INSTRUCTIONS: �dµI To be filed in person a by mail with the CountyAUditw or Counry Recorder o( Ne munry whele the property is bcated. � 1� 2 � � � Filing Dates: 1) Real Pmperty: Must fife dunrg Ihe yaar for which Ihe deduction is soughG � Counry Auditw 2) Ab6de / Manufadured Homes not essessed as Real Property Must Ae during Me hvefve (72) monfhs before March 31 oleach year the deduUion is sa.ght. � ��^��d� See reverse side � additional inshucUOns and qualificafions. 6}gS.gH 2@�rv-i-i= rt�8tro'ir� I MWmnt (owrer bN'ar - aee r@spirbms Mlarerse side) � � A. `� ' ' uU� VV• t1.i V( Assesse0 rahie U� poperty es d Mortpag e/ Contraa 4de6tedn¢v unpaid as W Mangage I ContraU Ma�d� 7, armrt ym Merd� t. Eate of ePP�� rc na �7+at h n"a � trer eou sl,sre ot mteress9 rc mN,ea .;m snrt�mre other � tt rerne m remftl's d�rtemnt tl�an tl�at of aOP��l tr�Ekam Eebw t�arre at mm¢ayea «mno-ars seae. '-� l�tA.0 U,�L.M.JL l.C'J..t Aedress d rrorc9agee ar mntraa uuv (nuMer end street �'1: 5am. ar�e code) Nartre of atignea or oNm o�met or holdm d rmtpage - � . Pdtlrnss ot asprea (numEe` arM street �: se Does eppl'�nt awn pOpEM1y in anY ONV i �` �./ ��m�a��� 20 20 _ itlne U Camty aiditnr I/We Pasm aulliorveE N Dra��•cr 10 ................... — Card NO. ..._`��'�`�...... � Na penalty W pe ry tt�at the above ard yer M the afore tioned rope me) (w rand aly,afe}e, 1 �y (edpprerpfApvneyorOylC&1.1-7i mon (numberan0 speeL �Y• sbta. aM LP o Rewrd dta618 ov/ne(1 Yes ❑ NO Fs Me P�O�Y in 7uestlon: M�u+aDY Assnsetl ❑ Rea� �o�nr ❑ i+m,!,a�N a�d :tea m propvty v�; ❑ ra zo _ zo _ zo _ 20 — �My Dete (rtanN. tlaY. Y��) g infortnation is true and cortect arW Mat the appli�ant is a resident of Itdiana aM ation is filed. Dam (morrth. deY. Y�+1 — _ — _ •.-< �__