HomeMy WebLinkAboutMortgage_Meyer (17)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T Year
+ FOR DEDUCTION FROM ASSESSED VALUATION
�-- . ,
State Fortn 43709 (R17 / 609)
�,�,� � Presaibed by DeparlmeN of Loml GoremmeM Firence
File �
INSTRUCTIONS:
Fartn @ed wiN: 1
To be �led in person or 6y maii wiM (he CountyAuditor or County Recorder of the oounry whe2 the pioperty is located. � �
Fi/irg Dates: 7) Real Pmperty: Must file dunng Ihe }rear /or which the deductlon is sought. �Cp d��
2J Mo6de / Manulactured Hortres not assessed as Real Property: Must file dunng the fweNe (12J months r'� $�,��7
before March 37 o/each yearNe tleduction is sought. •C.p�UCoun er
See reverse sjdejfor addifional instructions and qualA'ications (��„
Assessed raNe of rnal peoperty as d
Ma�U 1, unent 7,mr
I
If m, what is ha / her ezact share of interest?
It nartre m remrd 5 diflerent than that of aDPli
Name mntraau4er
Pddrea of nnrtoaoee w mntrad se�er (numl
31 aCSfXP�qf� // a _ aVD. C/� � O�� �O�/ P e nu�
V
age / Contraa cdebtednass unpaid as W Mwtgage / Contrao mdeMetlness �mpaitl as of is �he appliranl Ne sde
i 1, artenl yea tlate of aDPGption �ega� w eWita6le ameYl
❑ Yes ❑ No
If owied wiN someone dhcr �han sro�se. indimte wdh whom
sheet �: s1a1e. arrd ZfP code)
N�,.,e,a u��,,.,m.,..,eb.,.�...e.,.. ti.ue...e......��e
Num�' �v�(��
f��1..1; (11 J v� T�.IJ� '. ax
C
c �_ �/L� /� (�. ��
•`�C/� Q, O�
c?Ol! - 30$�3 —
[
20 _ � 20 _
AudRUr
COUNTY AUDROR
20 � 20 _
Counry
,�.—m/e P�PenY in puestim: Mnue%Assessetl
6Q �� �PQnY � Mnually Assessed
�IIIG7 ii251�15 �YC�Y
for artent yeaR
20 20 _
SleO on DropenY
Ves ❑ No
Date (rtqnfh, day, yea�
Fa�7
1/ We certlfy ulWer ihe penalry ot perjury that Ne ahove arW foregoing informatlon is We and cortect aM that the applirant is a resident ot Indiana and
ovmer I contract buyer of Ne aforementioned property on date appiiqtion is filed.
I�ulC (owneh MI name) (l �_ Date (nrnth. daY. Yea�)
sfate, ard LP ootle)
auNa¢eA Ey Eury exewted Power of Attomey rn by
person (numberard snee{ cIIy. 5fate. antl ZlPCOde)
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