HomeMy WebLinkAboutMortgage_Archer (3)"'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNE S n Tawnship Year
FOR DEDUCTION FROM ASSESSED VALUATION
SWa Farm A3709 (R8 / 2-07)
�6 � Aesaibed by DepeNnenl d Local Go�emment Finance
�NSrnucnoNS:
MAY 1 1 2009�e Marx
To be filed in person w 6y mad wrth tlre CountyAudifar dthe cou�rty whe2 fhe properly is located.
Fding Dafes: 1J Real Property: Dunng the 12 months belore Jurre if o/ the year the deduction is to be e ,(!���
2) Mobile Homes assessed imdar IC 6-1.1-7: Aelween January 15 and March 2 0/ the year fhe d '�'b6}plective.
Seereverseside/oiaddtiormlins6�ctionsandqualifications. QIBSONCO NTYAU@IiC�R
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. Key number / legal desaipUon
��-��-�a -��>v � ��
popaly as d March i. airenl Y�r M«tga9e / ConUact indebtedness
artarrt Y� � / . N �
his / her exect share
If reme on recad
or mortgagee «cvntraa seller (numner m�e stcret.
Name of as9gnea or dher o.vrier w hdder
Atldress of assignee
entl LIY WO6)
�perty in airy oNer I If yes. what
❑Yes ❑No
20 0 q I 20 _ 2q _ I 20
O
-�
as
nurriber
Is �he appfipnt �he sole
wdh mrt�eme ather Uwi spouse.
rnxnber
❑Yes ❑No
Is Ihe property in Questim:
�.. ❑ R�I Properly ❑ Moble Hane pC G7.
�� � I1,et• 1`rO �\ —
Car� 1`, d'4• •°•Y, _ °��, '�
0 ,
Inc.:-- .n property
` ""�'- _ • :5 ❑ No
20 2b _ 20 _
Date (monfh. daY. Y��
I/ We certify under the penalty oi perjury ihat Ne above and foregoing infomiation is true and mrrect and that Uie appGpnfs was I were a resident of
Indiana and ovmer oi the afotementimed property on March 1, ZO
�^atu(e (owners MI name) _ Date (monfh. daY• Y��
�f -a7pplicanl (n/�m�+6e� and s6eef. cdy. sf
:Xn� � "7�/`Q!'1 v CJ
dury enewled Pawer of Aliwrey w by
LP mtle)
Addre-,s of autMr¢ed persm (numbei aM s4eet my; sfafe, aM LP oode)
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