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HomeMy WebLinkAboutMortgage_Craney"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ip ea __, FOR DEDUCTION FROM ASSESSED VALUATION • State Fortn 43709 (R71 / 6-09) S EP 7 � w�. f Presmbed by Depanment ol Laal Govemrtrent Fnance 1 � 0 File Mark INSTRUCTIONS: To be fiied in person w by maii wiN the CouniyAud'ROr o� Counry Recorde� ot the county where the properfy is located. F ����,� F76g Dates: 1 J Real Property: Musf file dunng fhe year fir which the deduclion is soughL G IBS N J n� 7Qr 2) Mo6de / Manuladured Homes rrot assessed as Real Property Mus1 file during the 1weNe (12J rtanths before March 31 of each year the deduction is sought. ❑ County R�er See reverse side (or adtlitional instructans and qualfications. Appfrcanf ( ar d buyzr - see m reverse sid � q— Tapng Key numbu l legal deSaiDin^ Remrt1 num Page numbu a - - a3�GO � - � Fs Atise�ed vehre d real p'openy as d M1bngage / Cantr�ayapa irntlebtednass unpaid as W Mortgage I Can ' debtedness unpaid as of Is Ihe app�cani the sde 1AAazU1 7. MMf Y� Mart'h 7' �`7. / ` tla[e o( aPP�a� k9� ❑ Y�e mme(? L�� ❑ No li ro. WhBf 6 h6 / hPl 0i2C2 Sh310 011111CIESt? I1 name m remfd is d'AFerent Nan that of aPP��l �dipte Eelow or mntrad s�er (nwMer and stree; rdy. w other ovmer or Adtlrass at assignee (numGer end sheef, cGy, sfefe, arM ZIP ooda) Dces epptkaM wn property in any aNer I If yrs, munty in IrMi2na? r-� _. r-� _. zo zo uaWre W CamtyAUtlimr I/ We certify urWu the penalty of awner! ntra uyer of the a �nawre reme) II 'tlent aCdress o p�rant (numbe �ai s. ��-�� rson auUmr'¢ed W dNv exewted Pow SORIEMf Is the property in puesUm: Mnualy Assesse0 � Real Property ❑ Armually Assessed btobile Harie (IC 61. �� ���L �,�-�� SN�- ,��_ couNnnuom zo zo zo Counry �, � �5�1 +,�� zo W�P�Y iry that the above a� (oregoing infortnalion is true and corteU afW Nat the applinnt is a resident of Indiana arW ' ed property on date appiicabon is filed. �� c�. �r. r�n a�e o(AttomeY a M IC G7.1-12-0.7 Mtlress of auUwr'¢ed person (number arM Sbeet �; sb:e. 7�, �C7 Oate (monN. daY Y��