HomeMy WebLinkAboutMortgage_Hall" °°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
FOR DEDUCTION FROM ASSESSED VALUATION �
State Form 43709 (RB / 2117) � �
S I prasa0�etl M Depanment at �oral Go.emme�a Firmnce
HN
File 1Mark
INSTRUCTIONS: MAY y 2009
To be filed in person w by mad with the CourttyAuditor o/ the courrty where tlre properly is located.
Fding Dates: 1) Real Properly.� Dunng the 12 monMs be%re June 17 W the year the dedudion is to be eReclive.
2J Mob�7e Homes essessed urMer IC &1.1 •7: Behveen January 15 and March 2 of Me year the deduction is to b�declive�
See reverse side /ar add'Itiortal insWc6'ons a� queli(ications. 0��� �
(ownerarconbaci
T' i9riC ` eY rwmber I CesaiPib� Remid twmber Page tuunba
�l�-/ - o�- 3o3-ooa-�8 �-o a- � D 8 59s.�
0.� ralue of real papety as d A1art� i. anent Y� �Ba9e / CoNract indeMadness unpaid as of March t. Is the app6fant Iha sde legal a equitable owneR
wrtad year
'���/ 5 Q ❑Yes ❑No
I'�hat is h's / her eract share of uMrastl If ow�ned wMh sort�mne dher �Iwi spouse. udicafe wiih whom.
If rrome m recwd is Eifterent Ihan Ihffi d applicaru, i�mle belo+r. Is Ihe praperty in questim:
❑ Real PmoeAV ❑ Modle Home OC 61.1-7'
Narne of morigagee or mNact
neeress o( mortgagee ar mntr
Name of assig�e a dt�er oxn
,�� S� 3
sdlel (num6erarM stree4 dty. stafe. arM LP coOel
w hdder of mMgege
of assignee (rcmba` aM sGeet, city. sfale. antl
Doe^ applican� own W�nY in arry olher
couMy in Indiara9 �
❑Yes ❑No
Deducton approved in Ihe amowri of:
20 I 20
I! We certify under the �
Indiana and owner of ihe
itletrt address af
)� S. �-�
aWhor¢ed by duy
What Ta�dng D
COUNTY AUDITOR
�
- �[I' p,v o R� � �
�f` `�— � ' No
b
08,5��5
7—� /" A I�ry I Date (mmfh. tlay,Yee�
y oi perjury the above and foregoing infomiation is We and mrred and Mat the appGpnts was I we2 a resident oi
emention property on Mard7 1. 20
Dafe (monfi. daY• Y��
�straet dty. stafe, end ZIP e)
r�` nC�f-ol7 %nl �/7(0 70
�wer of Attmiev m W IC 61.1-12-.07 Dale (��, day. yea�
aers«� (n�mna.e,asrreec drr. srste, amziaWda�