HomeMy WebLinkAboutMortgage_Honeycutt^�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
:. —..
FOR DEDUCTION FROM ASSESSED VALUATION
• State Form 43709 (R71 / 6-09)
�' ,,,, p Presaihed by DepartmeM af Local Govemment Finance
File Mark
NsraucnoNS:
To 6e filed in � �� ��
person or by mail wifh the CounryAUditor or Counry Recorder ot the county where the property is loca ����
Fifing Dates: 1) Real Pmperty: Must file during the year for which the deduc6on is soughL � �dimr
2) Mobile /Manufactuied Homes not assessed as Real Property: Must file dunng the M1veNe (12) s,J�
before March 31 of each year the deduction is sought. e�ef
See reverse side for adddional instructions and qualifications. -
AppGnnt (o hacf 6uyer - see restric�pns� �sitla)
1 1 f C�.
(i✓ vi�.iu.i
�p�q KeY nu bel / legal desaiplion Remid n age numbg
6 - �-o o�- �s8- a8 ��
p�y v�lu¢ a( mal pmp¢ ,ry as W Martga e/ Con ct trWebtedness unpaid as of Mortgage / ConVacl inEehtedness unpaid as W Is ihe epp�iont Me sde
Ma�d� 1, arrent yrar Marrh yeer� Eate of aPP��m�b^ legal w equilade ame(.+
S D� ❑ Yes ❑ No
If rw, what's his / her exatl share ot interest? If ovmed wiN wmeone other than spouu. iMicate with wtrom
If �me m femrd is CMemn Uan Na� W aPP�^4'v�tlinte 6elow: Is tM ProPenY in Ouestim: Mnua�Y Assessed
❑ Real PmPeM ❑ �^^�Y ��
Modle Hwne IC E7.7-7)
Name of nqrt9a9ee «CmtraU seAer '
Pddress ot mortga9ee a mnbact seAer (number and streeG cify, state. ard LP )
vgnee or oticer owner w holder of morc9aga
assignee (number aM sbeet �y. stele. and ZIP ootle)
Doe^ ePWinnt ovm P�PeNY in afry olher Mas Ihis Oedutlion been reQUesfetl on p�opelty
�iLLyinlndana? �`�....... fwa�rentY�n � Yes ❑ Nf
❑ Yes
❑ "� � pra��•cr NO.. •
D�uc�on aPP�� u� ihe amount oE C.1 l� LL� �. ����• ••.•••
zo_ p— q"l�yy�.�� �— �—
SignaWre of Camb Auditw Counry Date (rt»nN. dzY. Yea�
I/ We certify under ihe penalty of perjury that the above and (oregoing intomiation is We and corteU arM that the applipnt is a resident of Indiara aM
owner I wntract buyer of the aforementioned property on date application is filed.
�___�._._..__....an.......e� . Date(norvh.daY.Y��)
F�I ieddent aGtlres of appGCant (n�Der and5Ree4 tlry, sbre, aro ur caae�
Pelson auNOraeE Cy dWy executed Fawero(ACtomeYa M IC 61.7-72-0.7 �� �^'�^�. �Y ��
Pdtlress of aulhaved persm (number aM sf+ee4 �; sbte, antl ZIP cotle) .