HomeMy WebLinkAboutMortgage_Butera"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
:. —.
; FOR DEDUCTION FROM ASSESSED VALUATION
S�a[e Fortn 93709 (R 71 / 609)
� ° Presaibetl by Departmen� of Local Govemmenl F�nce
ark
INSTRUCTIONS:
J�Ple4 2 1`�� �'
To 6e filed in person or by maii wifh fhe CounryAuditor or Counry Recorder o/ Ihe oounty where (Ae pioperty is �{
F�7fig Dates: 7) Real Properry: Must fife durirg the year for which the deduUion rs soughL Counry Auditw
2J Abbde / Manulactumd Homes rat assessed as Real Prnperty Must file durirn� Me tweNe (12/. jrwnths
6efore March 37 of eacA year fhe deduction is snughG `��J. �'� �Q Counry Recorder
See reverse side for additional inshuctions arM oual�cations.
AppGrant ( or m�trarf buyer- on re�erse sitle) � � �v
Taz ismrl ey nanber / I 1 desai R¢mrd ruimber Page nu
.Jfe- l�-D •ab3 -�01: g g i,D�SZ Il lel �
� C�W��Yas of I MMOrtgag�� tra� ebtedness unPaitl as af I dat�e of aooliration 'uWebtetlness unVaitl as af I I
eiatl share at interest? "' � If owned wiM someorie dher Ihan spouse.
IU��:T1
Name or mortgagee « contraU seUer
ACtlress of rtnrt9agee a wntraa seller
Name of assignee w dher owner w hdder ot mortgage
tlty.sfate,
Ooes applicant rnm propeM1y
munry in InCiana? r
Yes LI No
Is u,e v�P�y �� a���: n�nuaoy nssesud
❑ Rea1 aoaenv ❑ ,ornu,a�y Assessea
Has N¢ dedur]im been requeSteE m piopMy
forwrtentyear? � �
COUNTY AUDROR
Detluctim apprwed in ihe amoum of:
20 20 20 20 _ 20 2q 2(1
Sigratlue of CountyAud'¢or Coun�Y �(^�. EaY. Yee�)
I I We certrfy uMer Ihe penalry o( perjury Nat Ne above aM foregoing infortnatlon is We and correcl and Nat Ne applirant is a resitlent of Indiana aM �
owner I mntract buyer of ihe aforementioned property on date appliration is filed.
Sign wre (oxne/s fiN e) Date (nmth, dey, yeer)
�� ent addrecs W applinnt (num and sbaet riry. s1are. and Z/P mde) '
PCrson au ' ed Culy esecuted P of Atlwney or by IC 61.1-12-0.7 Date (mOnN, day, yBa�
Pddress N author¢etl person (number aM sLee4 dry. s+are, arM LPmtle)
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