HomeMy WebLinkAboutMortgage_Morton (2)"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coum
:�_,. : FOR DEDUCTION FROM ASSESSED VALUATION
Sfate Fortn 43709 (R71 / 6-09)
S ! Presmbetl by Department of L.oml Govemment Firance
�VSTRUCTIONS:
To be filed in person w by mail with the CountyAuditor or Caunry Recorder o! the couniy where [he pmperty is located.
FiGrg Dates: 1) Real Pmperty: Must file during Ne year for whirh the deduclion is sought.
2J Mobde / Manulactured Homes rrot assessed as Real Property Must fiIe dunng the hveNe (tt) months
before March 37 0( each year the deducfion is sought.
See 2verse side /or addrtior�l instrucUons and qualifications. G i
�AuoGrantloxmeroraonfraCb -seeresficborsmrevarsesidel i. � �
A1arrh 1. aa�eiri year
If ra, what Ls h'x I her e�ct
If �wrie on recad is dMerel
of aDP��t mdinte bebw
Name ol mmgagee «mntrarl sMkr
Address of mortga9ee w mntracl seller
Name af assi�ee w otlrer owner or hd
AACress of assgnee (number aM stree
Does applipnt awn ryoperty in any o�h�
approved'c� �Ire amount oE
mortgage
�•=re, antl
G(7
If yes. what munry/7
�bRry�dHor
;@eunN Recorder
tga9e I CanVa[Y c�tlebtetln¢s �mPaid as oi Is t�e eVW�� me sae
, of app6Ution kgal a equilaNe ame(.+
❑ Yes ❑ No
mmeorre other than spouse. IMi�ate wtth whom
Is Ihe praperty in 9ueslim: MnuaM Asses,eE
❑ Real Property ❑ amuany assessed . . .
wna� rapoq o�sv�aa
20 _ � 20 � 20 � 20 _ � 20
Has Nk aea�awd, nee�
tor cu�rent yeaR
20
G�nY
❑ No
20
��awre d Camb AWitw I Counry I Date (rtw+vh, daY. Y��)
1 I We certify under the penalry of perjury that ihe aDOVe and foregoing infortnalim is true and corrert and that the appli�ant is a resident of IMiana aM
owner / contrad buyer oi ihe aforementioned property on date application is fiied.
7n�p� (owrre(s fiN name)I I 1A __� � 6ate (month. daY, lea�
Person auNOraed by OWy executed Power
P4dress of authwtred persm (num0eram
ary, sYdte, and ZIP code)
cey, stale. aM ZIP code)
� oa� �n,onm. dar,