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HomeMy WebLinkAboutMortgage_Beraglia��nv STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun sh' Year z• �\ *: FOR DEDUCTION FROM ASSESSED VALUATION ' State Form 43709 (RN / 6-09) Gib50n �� �� � PrestnDed by Department of Local Govemment Finance rk INSTRUCTIONS: To be �led in person or by mail. Fwm fuetl vrim: Filing Dates: 1) Real Property: Must be completed and dafed in (he calen0ar year (or which [he Cetluction is souqhL C. . uditor Musf be lled with !he County Auditor or County Retorder ol [he county wheB the property is located on or be/ore January 5 0l the immediately succeeding calendar yeac ❑ Co ry� rtler 2) Mobile / Manutactuied Homes nof assessed as Real Property: Musf (le with the CountyAuditor ol !he GIB ON COUNTY county where the property is /ocated dunng fhe hvelve (72J months be(ore March 37 0! each yeai the deduclion is sought. See reverse side 7or additional inslluctions and qualifications. Apptiwnt (owner or wnVact buyer- see resfictions on reverse side) James P. Bereolia I vaNe o� feal property curtencyear �( no. what is his / her exact share of ir 50% It name on recortl is di3erem than Nat Key numDer / legal descriplion Remrd number Pa a number G- - o/-oQO, 5�d�� _o�� oio �a3 Mortgage I Contracc indebtetlness unpaitl as of Mortgage / Contract inde6;edness unpaid as of Is Ne applkant Ihe sole March 1, curtent year data ol applica�on '` legal or equitaWe owner7 S�(f U ❑ Ye5 ❑� No :erest7 If owneC with somaone oNer than spouse. indiwte with whom Rvan M. Dunn Name of rtangagee or wnVaa seller � � Atldress of rtwrtgagee or contract seller (number antl sh Name of assignee or other owner or hoWer ol rtrortgage Address ot assynee (number and sfreet, ciry, sfa7e. and �ces apolicant own pmoerry in any other counry in Indiana7 ❑ Yes appmved in tAe amount of: 20 _ � 20 CounryAu�itor stafe, afitl ZIP code) What Taxing DisUiC? RIUIYiiI:] Is Ne property in Question: MnuallyASSessed � Reat Properry ❑ Mnualy Assessed Moale Home (IC E7.7 Ha5 this Ei for wnem 20 ��!/ n '� lC rr �`i /�—� � - D(,�I,N j� JA�� P Ya N M I I We certify under the penalty of perjury that the above r ownef I COnVaGt buVeGOf lhe aforemen6oned proPerty or Fu0 resitlent adCress ot aDPti�6nt (numDer aM streel, crty 406 W Spruce St Princeton, IN 47670 Person auNOnzeO Dy tluy ezewted Power ol Attomey or Address oi authoraetl person do�o-��a� 20 �a:e �ted on property Yes ❑ No 20 �plicant is a resident of Indiana and 0