HomeMy WebLinkAboutMortgage_Martin (6)'°+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__,_ FOR DEDUCTION FROM ASSESSED VALUATION
�• Siate FOrtn 43709 (R71 / fr09)
,�' f Prrsaibed 6y DepartmeM of Lod GovemrtceM Fuance �
�� Fil ark
srnucnoNS: F� fl� �
To be filed in person w by mail with the CounlyAuditor or County Rernrder o/ fhe counry where the property i5 q�(�Q,
Filing Dates: 1) Real Property: Must file durirg fhe year fw wfiich fhe deducLOn is sought. M�f( 3 U ZO Z � �unty Auditor
2) Mobde /Manufactured Homes rwt assessed as Real Properly Must file during the fweHe (12) months
6efo2 March 37 0( each year the deductiar is sought C.�. —rc— ❑ County Recardu
See reverse side /or addifional instrucdons and qualifica[ions. �
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K numbes / legal desaiption Remrtl numb� Page numbr!
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Mor(qage/ Contrarl inde6tetlness unpaid as ot Mortgage I ContraU'uMeWedness unpaW as of Is Me �pGranl Ne sde
Mart�h 1, curtent yeer datc of appfrcation kgal a equitade amel+
p� �,Q�D -❑Yes ❑No
if ro. what is his / hu ezaG share of interest?
Ifname m remd's dAfemnt Itwi Nal W appl
Name of mortgagee or rmbact seller �
I
Address of mangagee ar contraG seDer (num
Name M assignee or other owner or hdder oi
Does appli<ant own yoperty
munry m Indena? r
crty, sraa, am �r coae�
streeG �Y• e�, a�^tl Z/�P� c�otle) �/
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y oNer If yes, what muny?
No
�cUOn approved'u� Ne amount ot
20 20 20
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KTat Tad�y Distriar
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❑ Real Properry ❑ Armua�y 0.ssessed
Mobde Flortie (IC 61.
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I/ We certify urWer Ne penalry ot perjury Ifiat the abo� foregoing infortnalion is W e and cortec[ arM ihat Me appli�ant is a resident of Indiana ard
owner I contract buyer of the aforementioned property date applicatlon is fiied.
SignaW lutl name) Date (monfh, deY. Y�a�)
FWI ' ent address of appfran� (num r ntl dty, slate, sM ZIP oode)
oy S (y',;� -' . ti767o
Pgson auNaaeO Gy dW/ exewteC Power a(Attaney or by IC 61.1-72-0.7 Date (monN, tlay, yea�
AEdress of aWmr'ved person (numberald sbeet, dry, sfate, arM ZIP ootle) .