HomeMy WebLinkAboutMortgage_Cutsinger (4)^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R11 ! 6O9)
- S f PreuribeE by Departmenl of Loral Govemment Finance
File Mark � �
�STRUCTIONS:
To be filed in person w by mail wifh Ne CountyAUditor or Counry Recorder ot the county where the pioperty is located.
Fil'mg Dates: 1) Real PropeRy: Must file during Ne year for which the deduction is sought.
2) Mobde / Manu/actured Homes rrot assessed as Real Property: Must fife dunng the hveNe (12) months
6efole March 37 0� eacA year fhe deduclion is sought.
See reverse sid for addiGonel inshucUOns and qualifications. ,
qppfxan orcanvadbul'er's�e�es��"lqns �es�)
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A� rdue d 2al pope
MBrUi 1. amenc Yrar
tl 110. whaf R h's / tl¢r erad
If fame on fecwd'a dMere�
Name W rrort9a9ee a
hare of intuest?
Wn that M appGCanl
ACOress o} mort9a9� w wntrad se�er (
Name of assignee w othei ox++er or hold
AdA2ss of asvgnce (number end stree[,
ooes apai�n� om, araaertr m a�r ourer
couiLLy m Ind�iana? ❑ Yes
20
in Ihe amount
r
�
f legal desaiplion Rem(d rwmbrl Pa9e numoel �
� _l/ � �� �?. 03�-0� d' o�o��, � �
Aortgage/ Con iMeMed�s unpaid as of Mortgage / Contrarl intle6tedness impaid as d Is Ne eppr�ant the sNe
Aaich 1. artent year Eale of aPP��^ legal a equifade ownM
� 9 �/Q ❑ Yes ❑ No
If owned wi� someone other Can sOW�. iMicate wdh xirom
nuriber end sbeel ciry. sbfe. aM LP code)
er of morigage
dry, state, an0 ZIP oode)
u,�s.,k,a�W,mHr w�t,
�- � p_
n2ture N Co�mb AuGimr
I/ We certify under Ne penalty of
ownecl conVad buyer ot the afon
�
ce�
20
that Ne above and foregoing infortnalion
ned �perry on date applicatlon is filed.
dAllomey or Oy IC G1.1-12-0J
sbee; ciry, state, anEZIPwCe)
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