HomeMy WebLinkAboutMortgage_Hartley°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township
v:._. '
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R8l 2-07)
�' 1 Presrnbed by Department d Local Govemment Finance .
To be fi/ed in person or by mad with the CountyAuditor o/the wunty wheia the proper(y is located. �� File {yiarlc -
INSTRUCTIONS: � � J
Fding Dates: 1) Real Pmperty: During tfre 12 months before June 71 0l the year ffre deduction is to be e/fective.
2J Mobiie Homes assessed under IC 64.1-7: Behveen January 15 and March 2 o(the year Ure deducUon is�q pe eR �vet008
See reverse side (or edditional instructions arxl qualifications. �J L r L
Appl c�,� ar ar mrrLaU dryu - see re on reverse sde) • �
� Y. n i n�; .. ..� P1� 4.�D� w 1- �� °�
Key number / legal desaipliarl�J
� 4- o. 33-
dMard�l.artentyrar MalAage/Contradindeble�
airrenlyear / � (►f.
is his I har exaU stare M interesl?
If reme m recard is
rtartqageaorcmuaciseuer /�'A��^� ^
�l '� J WI
of moM1gagee or conVad seller (numbe` antl sricet, tity, stafe, aM ZIP crode)
assignee a dher awner a holder of matgage
Addrrss of azsgnee (rcmiber and sVeeG �
Dces applrcant own property in erry dhu
caunry in Indiana7
❑Yes ❑No
Deduction apD�� � Ue amounl of:
0
Z/P wde)
If yes, whal counry?
COUNTY
20 _ 20 _
iess unpai0 as of Marrh 1, Is Ihe appfipnt Ihe sde legal v eqiutable owne/]
)6 " ❑Yes ❑No
If owned wM someane dher ihan spouu, i
Is ihe pn
❑ Real
quesUon:
y ❑ Mobile Home QC
DisUict7 Has Ihs detl�xtion 6een requested on praperty
r« wR�„� Y�n
❑Yes ❑No
20 20 20
���y o� ��yq�� Counry Dafe (monN, day, yea�
I! We cerfify under the penalty of perjury ihat Ne above and foregoing infortnation is We and cortect and that the applicants was ! were a residen[ o(
In�{ana and owner of ihe afwemenfioned property on March 1, 20
.7r�..e i.,..,.�eh Fn..n,,.e� . Date (rnaifh, OaY. yea�
Persan auUrorized by Cuy exeated Pwier of Attomey w by IC G1.1-12-.07 I Oate (mmN, day
Address of author¢ed parson (numberarrd stree4 ��Y. state, arM ZIP code)