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HomeMy WebLinkAboutMortgage_Bradley"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C Township Year :__ : FOR DEDUCTION FROM ASSESSED VALUATION � State Fortn 43709 (R71/609) �' � PresoiDetl by Oepanmenl of Local Govemment Fnance File a uvsrRUCnoNS: , To be filed in person w by mail wifh the CountyAuditor or Counry Recorder of the county where the pmperty is located. Pdirg Dates: 7) Real Pmperty: Mus7 file dumg the yaar for which [he deduc6on is soughG ` 2J Mobde / Manufadured Homes rmt assessed as Real Property Must fiie d�nng the fweNe (72) months G before March 37 of each year the deduction is wught. See reverse side lnr additional instnictions arM quali�cations. O'BS�N Counry Auditor GaunN Recorder Ia iStrvY KCynumDerll¢gal�esrnp Reco�tlnum0¢r P e mbPf -�� �- a- - /o3-vo3. 1��-0�2g O Ass�sed rahie d real praperty az ot Mortgage / Contract irWe6tedn�s unpaid as of Morigage I Conbact i�Webtedness unpaid as of Is �he appArant the sole MarU i, aarent year March 1, current year Eate of application legal w epuitade oxme(1 ❑ Yes ❑ No If ro, what a his I her e�] shara ot inteJrsi? If mmed wiM someo�re other Man spouse. ifdimte with hMm It nartie m iemd "n Nrterent Nan Nat oi aDP��• ��te below Is property in puestion: MnuaOy A�sed � �� Real RopeAy Q Mnually Assessed .._ I�t.J4.'.�.�i�'i:3 aM sbee4 �N. sfam. Name � acsionee or.othg.owner.or hdder of rtartoaae � � (�`� � ���o-vo a �A � �� �w eP X , `�v�i. an autho�aed Cy duty �ewted Power of Attorney or by IC G7.1-12-0.7 Pddress of aWwrtred person (num0er arM sbee; ciry, state, II fm COUNN AUDROR 20 20 Caunry 20 Dale (monfh. daY Y�� 20 v�vPm ❑ No going infortnatlon is We and wrtect arW that the appiicant is a resident of IrWiana arM �pliption is filed. le) „