HomeMy WebLinkAboutMortgage_Littlejohn^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
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FOR DEDUCTION FROM ASSESSED VALUATION
.• S�ate Fortn 43709 (Ri t! 6-09)
�' 1 Presaibetl by �epartment oi L.o�l Govemment Frence
�TRUCTIONS: � F �p
a r b N ry a a�nr �� CU�Z
To be filed in erson or b mail with fhe Coun Audifor or Coun RecoNer o� �he ooun whern the mp is located. � L
Filing Dates: 7J Real Property: Must file during the year /or which the deduction is soughG Counry Auditor
2) Mobile /ManulacNred Hortres not assessed as Real Prnperty: Must file dunng the tweHe (72) months C Reoorder
6efore March 37 0/ each year the deduction is sought. Ty
See reverse side for addifional inshucWns and qualifications. G I B
Anofuant (oxner ncmbaQ buYer- see rcV+j�liwts m reverse side) . /1 , n . 1
°f
Key fuunb legal desaipUm
�/ —/ �-/�!-2!
Assessed rWix of real piopn�:Y as d !
Ma�Ci 1, tlr�eN Ym !
u�, wnai � ms � ne� exaa � or N�sn
I( �ume on �ecdtl s tltlfe�t Nan ihat ot applirant
Name of mwt�jagee a mRa'act se0e � .
Addrea of �rotqagce
/ ContraU'ud�tedr�s unPaid as o(
and sveeS �: �te. ard ZIP coda)
p�yme o{ asyg�¢¢ y othni owner w twlder of mortgage
ACdress of assignee (num6er aN sheet �Y. �e, antl ZIP code)
Oces applitant o.m properry in any oNer I( yes. what county7
munry in Irid'ana? ❑ Yes ❑ No
Dtductlon approvetl 4� ihe amount
20 _ 20.
$igretlire U CAUnb MWi� tOr
�
�9a9e / Contract udebtedness imDaitl as d Is Ihe aP�� tlre sale
� o( aDP�� kgal w eWitaWe owneY)
❑ Yes ❑ No
someone oNer Nan soouse. iMifate wtrh whom
y �E
Wlfat Ta�dnc
)UNTYAUDROR _
\
20 20
Is ihe v�Pe�Y in puestion: Mnualy Assessetl
�Rea� amcem ❑ a„rn,a�ywssessea
Molvle Hm�e fIC 61.
�HN �YiU�'�
R�ti�'�
I�� JW��
Zp_ � 20
Date (mmfh.
J
1 I We certify uMu the penaly oi perjury that Ne above anE foregoing infortnation is we and cortea a(M ihat the applicant is a resident of Indiana aM
owner I contraa buyer of the aforementioned property on date application is filed.
3� (o� . n t) �i.\%.`c"'�" Date(nm7h.EaY.Yea�
ril}; sfate, aM ZIP cotle)
ezewted Power of Attorney m
person (number arid streeL dry, sla�e.
Datc (monN, day, yea�