HomeMy WebLinkAboutMortgage_Harbison (7)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Yeat
_ s FOR DEDUCTION FROM ASSESSED VALUATION
• State Fofm G3709 (R71 / fi09)
�' � Pfesrnbed by DePa�rM1 of Loml Gwemmenl Frence
ile Mark
INSTRUCT70NS: J �
To be (led in person or by mail witA the CountyAuditof or Counry Recorder oI the county where the property is locafed.
Fifirg Dates: 1) Real Pmperty: Must fi/e dunng the yearlor which the deduction is soughf. � Counry Auditor
2) Mobde / Manufactured Homes nof assessed as Real Property Must file dunng the hveMe (72J months ^
6etole March 31 o/each yearthe deduction is saighL 6J,,,J Recorder
See reversa side leraddiGonal instructi�s and qualifications. COUNTY A
AooGCan{(oaaeramny+s76uvef4see onrcvdseside) 1 1 . 6{BSO
D�svwt
b^I�C�
Name o1 rtrongagee a amtraU seller
nnaress a rtiortga9ee or rmo-aa seo
Name oi asvgnee or other o�mer m Y
Indiana?
any oNer
Yes
Deducfiw� epproved In ihe am0unl ot
aGP��t'u�Ekate bebv.:
slat
�� .�.w,�..�.. � . � �.._...w
aiE az of Mortgage I Con� maebteCness unpaid as of Is Vie e0�� ��e
date of appfKalion legal w epuitaWe ownd.+
❑ Yes ❑ No
If awned wiN somrone other ihan 5pouse, indzate uiN whom
Is tl�e property in QursUOn: Mnuelly AssessN
❑ Real Property ❑ ArmuallyAssessed
N� Dl'ail'Cr NQ... q�(�j�
— Card \`O. ...r�� 1
� �i-IO�OC�a............
m plopPfly
❑ No
zo zo zo �� _ zo Zo _
Sigrature of Coimry Audimr Counry Date (irqnth. tlaY 1'ee�
1/ We certi(y uMer the penalry of perjury thai the above aM foregoing informatlon is W e and mrrect and Nat the applinnt is a resident of IrWiaria and
, ownps / mntraci buyer of ihe afwemenboned property on date appliption is filed. � .
��
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Person authoraed by duly ez¢tvt2tl Power o(Atlomey V by IG Gl.l-1"1L./
Mdress of auNOrrzed person (number and saeet. cdy, state, an0 LP oode)
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