HomeMy WebLinkAboutMortgage_Lutzs�•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS q Toamshi Year
3,, .., FOR DEDUCTION FROM ASSESSED VALUATION �
Stale Form 43709 (R8/ 2-07)
�� �y�� ' Prescubed 6y Department of Local Govemmenl Finance
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INSTRUCTIONS:
To be filed in person or by mail with the CountyAudito� ol the couMy wheie the property is lowted. � �y,,
Filing Dates: 7) Real Property: Durrng tha 12 months belae June 11 of the yeer the deducGon is to be elfec6ve. 9!�c«t ,�j�
2) Mobile Homes assessed under IC 6-1 J-7: Behveen Januery 75 end Mareh 2 0/ the year the ded �y is to be,�ecGve�
Seereverseside/aeddi6onalinsbuctionsandqualifications. �'G'���'��; COUP!TY p,��p�7po
Apy�can�
Key number I
popely as ol Mamh 1. ctnenl year
whal is ha / hei ezacl share of interesl?
If name on recortl is Cifferent �han �hat of applicant, indipte below:
mortgagee or canlract seller
P.dEress of moM1gagee a wnVad seller (number and sbeef,
Name of assignee a a�her wvner or Mlder ol mortgege
Atltlress of assgnea (numbuaM sfreet, dty. �efe. arM
Dces appllwni own property ln any dher
counry in Indianal
❑ Yes ❑ No
Deduction apprwed in ihe amwnt of:
�
Sig�ture of CounrylwdMr
20
,�$-��1-��.30/_G�
indeWedness unpaid as of March 1,
ar�d ZIP code)
❑Yes ❑ No
If owned with wmeone olher than spouu, indicate with wiwm.
Is ihe property in quesUOn:
❑ Real Property ❑ Mobile Hare OC 61.
!d �/
,�,a,T, D�����-��- �o-�Q4�..��.5,-3 ��
❑ No
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��oR� � �,.a ����o.�...�.......��.,� �:�/�.
o ��� —
20 I 20 � 20
20 _ � 20
I I We certify under lhe penalry of perjury that ihe above and fwegoing information is We and corted and tlial 7ie applicants was I were a resident o(
Indiana and owner of l� afore�entirned property on March 7, 20
inaWre (owneYs 1 Dale (mMfh, dey, yeeQ
code)
by tluy exewted Po.ver of Attanay a by
persm (numDerentlshse4