HomeMy WebLinkAboutMortgage_Meeks (6)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou i vear �
.,.__..
. FOR DEDUCTION FROM ASSESSED VALUATION
� S1ate Fortn C3709 (R11 ! 6-09)
�' Presuibed by DeVa�M of Loral GwernmeM Financa
� il Mark
INSTRUCTIONS: .
To be filed in rson or b mail wifh the Coun Auditw or Coun Recorder o/ the coun where the ro F� �� �
Pe Y tY �Y b P PehY is bcated.
Filing Dates: 1) Real Pmperry: Must file dufig fhe year /or which the deduction is soughL ��. �����Auditnr
2J Mo6ile / Manu/adumd Homes rrot assessed as Real Pmperty Must fiie dunng Me tweNe (72) months ❑
before March 31 o/each year the deduclion is snught. u ecorder
GIBSO
See reverse side fnr addifbnal instrucGOns and qualificafions.
MP�ni (owlrerorcontraU buyar- see msVi�xa on 2verse side) .
�
1 rakie ri real PmpertY a
arrerrt yrx
Name oi mwigagee «mnVaG seller
Pddms of rtnrtgagee a contraa
Name of asdgnee Wr ahei owner
r/legal
_�s
Indit�ate behw
stree4 ctiY. sfate.
stree4 �1: �te, aM ZIP cotle)
RernN numbni Page number
_000_ os?- o d-8 ao i r 2- �Yl
iMehtedrress unPaid a d Mangape / Contrafl cWebtedness imG� as d Is tlm aPd��t tlre sde
�r Eate of aGP�� � a ��e �
DOD ❑ Yes ❑ No
If awneE vriM someo� oNer Ihan sDa+�. iMicate wnh wtnm
C_
P�
Does appl6ant own property in any aUtt I If yes, what munt�? I NRaI Tap�g Distrid7
munry in Ind'ana? _ _
❑ Yes ❑ No
oa��mm, avwo+�w m me
�— I � I �
I/ We certify under the penalry ot perju(�that Ne
owner I contract buyer of the aforementioned pro
�nanue (o.mers Ntl name)
Is ihe property in quesaan: Mnualty Assesse0
❑ Real Pmperty ❑ Armually Assessed
Oeen requesteE on praperty
_ --^_"__r. No
COUNTYAUDRC �� �
Dra�ver \'0..�.��........
20
Card 1\'O. .......°.�.�........
��ry .#sH,�ao.� -
foregoing infortnalion is ,.,.� o� �� w� � eu ai w uui uie appnran[ �s a resaent of Indiana aM
date application is filed.
FWI tetident aEtlre� OI applianl (wmEer and sbee( afy. 51afe, antl LP ca
� � I � � ��' f ,t"� .� -��,.,,�.�
Pefson 0u0q�L by EtYy ex¢wted Pormf af Altorney IC 61.1-12-0.7
AOtlress W auUmt'vEtl person (numberaM sbee4 mY. stafe, and LP code)