HomeMy WebLinkAboutMortgage_Hulfachor (3)� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_ s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 43709 (R77 / 6-09)
�,,,, � Presvibetl by DepartmeM of Locai Govemmerrt Finance
File Mark
INSTRUCTIONS:
Fortn Ned wRh:
To 6e filed in person w by mail with tlm CountyAUdifor or Counry Recnrder of the county where the property is located.
FiNrg Dates: 1) Real Property: Must file dunrg the year /or whicA Ne deduction is sought. � Counry Auditor
2) Mo6Re / Manuladuied Hanes not assessed as Real Property Mus! file dunng the twelve (12J rtanNs ❑
be(we Mamh 37 oleacA yearNe dedudion rs saght Counry Recordu
See �everse side /or additional inshucUons and qvalifications.
Appfimnt(ownsrar b -aea m side)
Ta�dng 0' � / le9al tlawiption Page
D
Ass�sed vaWe af r� PoP�Y as d M� `q�9e / Contrau "udebtedness unpaid as U Mongage / Conrxt c�tlebndness unP� as ot b tAe eCW�t tha sde
A1�h 7. anem rear Mamh 1. a,rre�rt yenr mte or sca/�1 /�y� �al «epWtaNe o�wn
I � /l' / .11 .t J ❑ Yes ❑ No
tl m. what 5 hiS / htt euG 5hare of intemst?
M nartie m remd'n 6lfrmn[ Nan Mat of aDP��C ind'vate Debnc
Name m muteasee or m,esa un« � �l
V'
ACdres d mornja9ee a mntrad sn�er (num6u ard straeC �Y• sfate. P code)
Nama ol assi�Fee w oNU awner w halder of mM9a9e
PdCress oi asd9nea (number eM snee4 dry, s�. and ZIP cade)
Does appti�nt am pmperty in eny oNer If yes, what munty.+
cwnty ui Intliana? r-i .. r—i ..
with wi�an
Is Me property in Oues}im: MnuaOy Assessed
❑ Real PmPeNY ❑ �!+�N �
DisUkl? Mas Ihc deductian baen reGU�ted m p�aprlty
tor wrrent Year' r� .. r�