HomeMy WebLinkAboutMortgage_Deisher"^ STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
S�ate Form 43709 (R10I11-08)
� � PrasuibeC by DePaNrent d Local GovemrreM Firtanm
iNSrnucnoNS: � � �Fi M �
To be filed in person a by mad witir the CountyAuiifor o1 fAe county wheie the poperty is located.
Filing Dates: 1J Real Proper(y: Must h7e dlaing the yea� lor which fhe deduction is sought.
2) Mobde /Manulactured Homes not assessed as Real Property: Must file dunrg tlie tweNe (12J mmths 6e/de Malch 31 0l each yea�
maaaa���«,yr,c JUL 1 2009
s� ���se sae � addruo.,� rnswcuo� em q�r�rcaaon�. .
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� Marrh7 auierttyaa '
Y m. whal is h¢ / ner eratl share d iNerestt
C rema on recad a GMeraM �han �hat o( aPG�. iMimfa Eebr.
Name d mortgagee ar canlad seAer
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naerass a mongapBB «mreaa saner (in.nxrane 5woc �: st
Nama d essigrrea or a9ier owner ar MoMMer of malBaBe
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Ooes appi�nt own pmpe(ty in ary alhar
camly in IMiare1
❑ Yes ❑ No
oeduaim aaorwed in ma amoura d:
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Signaf�ra d Cwnry Auditw
I/ We certify unaer the penaity of pe�ury ihai ihe
owner / mntrad buyer of the aforementioneE pfq
� 'gnatu (wnwrsMiume) '
_ / � aaareu d evd�,� ���e� , a
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Parson auihorized by duy ezaated Power MAnnmey a by IC 61.
parsm (nun6er arW s+roat �Y. sblo.
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IedresunpaitlasW Morlpapa/Conlrapu�deM¢dnessunmiEas
legal u epu3abla ownaR
❑ Yes ❑ No
somao� Mer Uw� sPa'+a. ind"cata wilh winm
fs Ne pmparty in 9uaslian: Annually 0.asessad
]Re.alPrapeAy ❑MnuallyAssesse0
Mobile Hortie (IC 67.
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Insurance and Risk Management for Local Governments
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