HomeMy WebLinkAboutMortgage_Heldt (11).� °"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
,�,°�.� FOR DEDUCTION FROM ASSESSED VALUATION �
State Fortn 43709 (RB I 2-07)
°; � Presaibed by Departmeni of Local Govemment Finarxe
File Mark
�NSrRUCnoNS: MAR 2 3 2009
To be Fled in person or by mail with the CountyAuditor o! the county where the property is located. �
Fding Dates: 1) Real Property: Dunng the 72 months be%re June i7 o/the year the deductlon is to be eRective.
2J Mobile Homes assessed undei C 6-1.7-7: Behveen January 75 end Ma2h 2 o/the year the deduction is (e-Qq,e��G'v��
See reverse side for additiona! instiuctions and ualificafions. ��( �63
-see
value of real poprily as of March 1,
what is his / her exad share of irrtemsl?
rume m
Name
�rlleyaltlBSCn n O� /�
/ - a30/- 00/. ���'- ��
:nt year Mortgage / Convaa inCeWetlness unpaid as M March 1, Is Ihe
artenl year / n � �,�.� .
ot rtangagee w mnuad seller (number aM;Gg§f. dty.
Name of asagnce or Wier mvner or hdder of mwtgage
Address of assignee (number and streeL
Does applicarri oxn qopeRy in any alher
coumy in Intliana?
❑Yes ❑ No
�eduction app�oved in the amount of:
Yi�]
Si9naWre of CaunryAudROr
� °�;
- '.i
someone
arM ZIP mOe)
ict7
Dra�r�cr NOr.��Q�•••••••••
Card NO. � I 7�D
# G�l, 7p5. �--.. . . . . —
spouu,
is me w�m
❑ Real Prop
u,a sda i�i � �w�we w�,an
❑Yes ❑Na
❑ Mobile Home pC 61.
Has Vus tleduction been requesled on property
tw wnent yral?
�Yes ❑No
2�
Date (mmN. daY•Y��
20 _
I! We certify under the penaly of perjury that the above and toregoing infwmation is We and cortect and that tlie applirants was / were a resident of
Indiana and owner oi the af ementirned property on March 7, 20
r�i (owners hn� nanie), // e.f oa�e (ma�th. mr• rea�
�
and sheeL city,s(ate. aM
Atinmay or by IC
Address of aulhor¢ed persm (numbe� aM sbeeL dty, sfate, aM