HomeMy WebLinkAboutMortgage_Marquise Enterprises LLC� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_, • FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fwm 43709 (Ri1 / 6-09) Q
•�' ,�,� 1 Presaibed by DePart��t oi Local Govemment Finance �.`
File Mark
�urRUCnoNS: �- � - a0 I o� F����
To be lled in person w by mail witA the CountyAuditor or Counry RecoNer o/ the counry where tAe property is located.
Fii'mg Dates: 1) Real Pmperty: Must fiie dunng fhe year /or which the rleductlon is sought. � County Audimr
2J Mo6r7e / Manufactured Homes rrot assessed as Real Pmperty Must file dunng the fweNe (72) monfhs
6etore Ma�ch 37 0( each year the deduclion is sought. ❑ County Recorder
See reverse side !or addi[mnal instructbns and qualifications.
AppG`any(pYqer w contrad byrer - see resMrlp�s m le` rse side) , 1
d-U"!"itJl- 1`J[
Mortgage/ Contraa irdebteErress unpaid
Mard� 1, arte91year
I her eu� shara of internst?
m mord a drtFVrnt ihan Nat
Name of rrotgagee a mntraG
Address of rtiorcga9ee a ranbad se�er (num6er and sn
Nartre of asignee w a'her wmer w holder of matgaga
Adtlress ot assignee (m�mdr! antl street �1: sbte,
pces eppli�2nt a.m ynperry in any ofher
munry m IMana? n Yes ❑ No
�
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annunc or.
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[
a
as of Is Ne apd�t the sde
legal w epuilaWe awneYl
❑ Yes ❑ No
wmeone other ihan spouse. iMicate with whan
Is Cie P�PQnY in Question: MnuaDY Avessed
❑ Real Property Q N�rtu��lly A�ssed 1.
BO/J A P/-� R� �w��,°�^���'°^,�,,,
%�/7%�.>I-�%�"��_.D xcurtentyean ❑ Yes ❑ I
Q8-da lO
�— ��- ��'�.ws
I/ We certlfy uMer the penalty of
owneLl conVacl buyer of ihe afor
�
��
�o _
�. the above and foregoing intortnalion is We and mrtect arid Nat the applirant is a 2sident of Intliana ard
property wi date lication is filed. /+'�
_ _ �� `� e (` � / � Date (month. daY•Yge�)
1% ] �2 �`iiS
ary, state, and ZIP oode
IC 61.7-12-0.7
AOCmss of auNOrrzed perswi (number arM sbeet, dry, sb(e, and
Date (month. OaY. Y��