HomeMy WebLinkAboutMortgage_Holzmeyer� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year
; FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fortn 03709 (R71 I6-09)
`` rresaitea M oeparmiea a Local Goremmeru Fuance
File Mark
wsraucnoNS:
b be fiied in person or by mail with the CounryAUditor w Counry Recorder o� the county wf�ere !he property is Iocatedi�l�1Y
Filing Dates: 7) Real Properry: Must file dunrg fha year for which fhe deducfion is soughf.
2) Mobde / Manufadured Homes not assessed as Real Property. Must file dunrg the nveHe (12) moriths�
6etore March 37 o/each ysarNe deduction is saght. �
See reverse side for tlition inshucNons and qvalifications. ( ___, ,
m.
f vah�e d mal p�operty as a(
a�e yrar
of inte�esY!
��� �
tt rerne m remftl'a 6Rurnt than that of appBwn, trdi�ate Debw.
Nartre m rtnrt9a9ee or mnasct seller
Addtea of rrortga�ee or
rtiortpage
dly, Stete. eM ZIP Code)
Auditor
Recorder
Page �vunbrl
i as d I Mortgaga I ContraG h�EebteCnass �mpaid as W �s Ne epp�mri the sde
Eate of appGCation legal ar equitade ovmell
� ❑ Yes ❑ No
If awned wiN someone other than spousa. Indi�te with whom
Is Uie MoPP+�Y'u� Vu�tlan: MfxisOy Assessed
i�RealPfoperty �l�NluallyAssessed
C nuntyl What Tarirg D'aviri? Has Niv deduGion been reQUesied m prop�ty
o - far arteN YeaR
_ ❑ Yes ❑ No
_ Dra���cr NO....� .�.. � �.......
�j . • • • • COUNTY AUDROR
` �1 1�-
Card i�'O . .............
- zo zo zo zo
� (�� �Sl�c�-� — — —
_ - I Caunry Date (monM. �n� �— I C7
I I We ce urWU penalty of perj Mat the a6ove and foregoing infortnation is We and correct arM that the applicant is a resident of InCiana and
owner / contract bu of the afaementioned property on date applualion is fileA.
,S;re �pt i�YShNiamel i i Date(rtrnfi.daY.Y�A
Pason auCia@r�
�
by IC G7.
pem.on (number antl sbaet �l: slate. Bn0 ZIP oode)
�o