HomeMy WebLinkAboutMortgage_Epperson^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Court
�/71 FOR DEDUCTION FROM ASSESSED VALUATION
�I/ State Form 43709 (R11 / 6-09)
�/�Y� �' P'esaibetl M�Pa�rd ot Lad Govemmem Fuance
6{ w.
� iNSrnucnoNS:
To 6e fiied in person w by mail wiN the CounryAuditor w Counry Recorder o! the oounry where the properry is located.
Frfig Dates: 7) Real Property: Must file duting Ne year for which Ihe derluction is sought.
2J AbbDe / Manutadured Homes not assessed as Real Property: Must fi!e dunng the fweNe (12) months
be%ra March 37 of each year the deduction is souqht.
See raverse si0e /or addrfional inshucGOns and qualfications. G IE
AGV6 t(ownerar r-see onre�erseside)
T Distrin ICey �wm6er / legal desaiptlon
,.�_ - - - �oa- �.4 �r.�,a s�
Y red poPem/ az d . Mortpa e/ Contracl IntlebteE�s unGaid az of
ymr Mart3��wj�rncy�yr �
tt na what � ha l her tsact snare of inrelest?
If name m remN is ?Afeiait Nan Nal of appOpnt, uWicate bnb+l
Name ot rmtgagee or mnbad se4er
AddRSS of mortgagee ar wntraG sn�
othu owner m hdder of rtartgage
(number aM snee( rdy-•'^!^-�
DP:IIVCP \`�..�Q�O
Card NO. ....rJ, g I.
...........
�afi,ao�. °0
uces ePq�n ovm propeny in any omer
munty in InOiana? � Y25
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crty, sfete. aM LP rode)
r°2010
Counry Auditor
�'qynN Recadv
��
I ❑ Yes ❑ No
wmeone ather Ihan spouse, ud'xate with whom
Is Ihe P�PertY in Vuestion: Mn�eOY A4sessed
❑ R� a�oaenv ❑ :om,uaMwss�a . . .
� e� reQU«�ee o� c�r
� ❑ Yes ❑ No
� � — �— �°—
Sig(anae d Cwnb Audimr Couniy Date (monM. daY. Y��
� I/ We certify under ihe penalry of perjury that the above and foregoing infortnation is We and cortect arW that Ne applirant is a resideM o( Indiana antl
er I contracl buyer of Ne aforementirnad property on data application is filed. �(� �Y �n
' renue (oyrers N9 name) M /' _ _
iaDP� t(numberard L�Y. �„� LP_�� l l v�V "_'_' _ _
�V�
Ley e=ewted aower oranwner w M �c 61.7-1z-0.7 � oate (m
person (number arid sneeC dry, sble, aM LP cotle) .