HomeMy WebLinkAboutMortgage_Bradshaw (2)""* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
= FOR DEDUCTION FROM ASSESSED VALUATION
iF •.
• Sfa[e Form A3709 (R71 / 6-09)
, j Presaibed by Depart�rieM of Local GovemmeM FrNme
File Mark
INSTRUCTIONS:
To be filed in person w by mail with Ne Counry Auditor or County Recorder of fhe co�nry whefe Ihe pmperty is located. Fwm med with:
Fiiirg Dates: 1) Real Prt�perty: Must file dunig the yaar for which the deduUion is sought. � Counry qudimr
2J Mobde / Manutactured Homes not assessed as Real Pruperty: Must Ae during the fweNe (72J months
before Ma�ch 31 0! each year the deduction is sought ❑ ���Y Re��e�
See 2verse side /or additionaf insLuctions arM qualilicafions.
AoNrent (ownertoccontrart buver -aee lesMCtions m reveru sidal n ,.
o�=.�a� ��.� i.� i�.a I� -uD I- oc
ed vaNe d real property as of Mor[q age / Cantract iMehtetlness unpaid az ol
I. qrmnt year Ma2h 1. airtent yrar
evxt
m
Qt rrort�agee or mntract s 1 r
Address of ma ce w mntrad se0er
Name of assi�ee w Whei ovmer or hd
lifant ovm pmperty in any oNer
Ind"ana? ❑ Yes
Deductim aPP� in ihe amount
20 � 20
tdy, S1atB. BM ZIP tode)
mortgage
state, and ZIP code)
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�
20
VAk
Rewrd numEer Page numbel
B S 5 1.
�mpxiE as ot Is Ne appArant the m
le9al or e�tade ovm
someane oNer ihan spouse, u�drate Wth wtwm '
�iM D�PeKY in OuesGOn: MnueM Assessed
22� PNPCfIy ❑ MtlUally ASSCSSP.�
� Mobile Fiome fIC 6
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20 ' 20 �
20
Ii0
Sig�tue of CoumY AuGiwr I Caunry I Dete (rtrmN. daY. Sea�
I I We certity uMer Ne penalry of perjury that the ahove and foregoing infortnalion is We and cortect ariC that Me applirant is a resident of Indiana arW
owner / mntract buyer of the afaementioned property on date applicatlon is filed.
0
Puson auNO�aeE Cy Cuty exec�Gled Power of Atfwney or by IC Cri.1-12-0.7
ACdreSS oi authorrzrd person (numberantl sbeet, ciry, SYdle, and LP oode)
Datc (monfh, daY, Y��