HomeMy WebLinkAboutMortgage_Couts"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_,. _ FOR DEDUCTION FROM ASSESSED VALUATION
� Sfate fortn 43709 (R71 / 609)
�' ,�,� � Prrsoibed by OePaM�M of Local GwemmeM Frence
INSTRUC770NS:
70 6e frled in person w by mail wifh the CounryAuditw or Counry Recorder o7 the county where the pmperry is located.
Filing Dates: 1) Real Pmperty Musf file during the year fw which the deduclion is sought.
2) Mobde / Manufactu2d Homes rrof assessed as Real Property Mus! fi/e dunng the fwelve �72J monMs
before March 31 07 eacA yenr the deduction is sought.
See reverse side 79c�ddi[ronal instrucfions and quali�cations.
�MP�m (owrier vap 6yye� ; see rashirdons o�verse vtle)� �8
her exaG share of
- or -ci ru - uu 7. - uc� - u
Mortgage/ ContraG'uWe6ledness unpaid as of Mortgage I Ct
Mamh 1, a�rtent yeer date ot appGc
�f awned wiM sarneone
If name on remrE's QMerent Nan Nat af app�n4 ��b�e bebw.
Name of rtevtgagee or mntrarl seller
Pddress of rtprt9a9ce or
Name
mortpage
��urnne, a�d so-eet cur. smre, a�e z�a ��
finnt own property in any oNer I I( yes. what munty?
ma��aa
❑ Yes ❑ No
U Eo�aryauaito�
� ❑ nry Recarder
OR
I number Pa9e nu
GG �G
as of Is ihe appGont the sole
legal w eqWtade ownM
� ❑ Yes ❑ No
with whom
Is C�e praperty in 9ue5DOn: Mnua%ASSesv.d
�Real Property ❑ MmuaOyA�sessed
aoo9
D1'II11'CI" \� ...................
- c���a �o. ....5.8�........ �,P�
� �' ��� 3�1 G . rn� , ❑ Na
COUNTYAUDROR
Oetluctlon approved in ihe amwnt of:
20 _ 20 20 20 20 _ 2q 20
SignaMe W CoumY Auditor Caunry Date (month, daY. Yea�
I/ We cer4fy urder the penalry of pe�ury Nat Ne above and foregoing infortnalion is we and mrtect arW Ihat the applinn[ is a resident of Indiana arW
rnvner 1 mntract buyer ot ihe aforementioned property on date appliption is filed.
Sigfaw�e (owie�h /iGID /n�a �y Date (norcA, daY. Y��)
✓�l 4 /� OL' .
Futl resident aEtlrnss of a�p,p/�wnt (number a 4 d, atate, ard Z7P mtlea)
�Q� ///, '7i�«l S� V/iN(PCGI /i� ���G��
a e F.. o n au m o r a e d e y e W r execu re a a o w e r o r a t w n er « M� c G 7. 7- 1 2-0. 7 o a t e ( m o n M. G a r. r�
PEdress of aWror'ved person (number a�M sLeet. ri1y, slate. and LP mtle) . . ' _