HomeMy WebLinkAboutMortgage_Lord.� °^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
r,.: FOR DEDUCTION FROM ASSESSED VALUATION
� S�ata Form 43709 (R8 / 2-07) _
�6'y,. � Presaibed by Department of Local Govemment fi�nce �
��File f�va :
INSTRUCTIONS:
To be filed in person or by mad wdh the CountyAuditor of the county where the property is located. � �E'C 2 �1
F�ing Dates: 1) Real Property: During the 12 months be/ae June 17 0/ fhe year lhe deduction is lo be etlec6ve. �i
2) Mobila Homes assessed under IC 6-1.7-7: Between January 15 and Maich 2 0l the year tbe deduc6m is to be eflecbveo.8
See reverse side la additional insWctions and qualificatirons. �}„
c6on On reverse stle)
Q� Key n r/legaldescypyon
� ��) �
ralue of real poperty as of March 1, arrent year MMgage /(
wnenl year
If ro, whal is nis I ner ezaa share M imerest?
�me on record is dit(arent Nan that of appliranl, intlinle be
Name of rmr�gagea ar contracl seller
�
Atldress of rtwrtgagee or mniraG seller (number aM , ti
Nama af asv9rree a oUier awner or hdder oF inatgaga
Addreu W assigriee (num6er aM sfreet, city, slate, aM ZlP a
Does applicant ovm property in any olher It yes,
county in Indare7
❑ Yes ❑ No
Dedud'wn appmved in the amounl of:
20 � 20 20 _
p
Sigrawre of Counrylwditor
cotle)
0
�
unpaid as oF March 1, � Is ihe applitant Ihe sda legal a
It owried wiUi wmeone oUer Ihan spouse. �cate wiN
❑ No
Is the property in question:
❑ Real Property ❑ Mobile Home
_�
:,i f �0�8-.����- �
TexingDisirict;�:1 Dra"'c' �
20
/].. �••....- M
1.N X�°' d/,°� '�W �"' ^" J�I,.J�
1'
20 I 20
I I We certify under the penalty of perjury that Uie above and foregoing infortnation is true and mrtect and that the applicanis was I were a resident of
Indiana,�nd owner of the aforemenboned property on March 7, 2p _
a
of applicaM'(number end s4eet. city. st e. aM Z/P coCe)
�Aln�£ pv�n� u� iUNC� ion/, �1 �17 (a� o
tluN executed Po.ver of Nfaney d by IC 61.1-12-.07
persm (numberaMSVeef.ciry.stafe,
J
c,rrnm. dar rea�