HomeMy WebLinkAboutMortgage_Muncy"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ � FOR DEDUCTION FROM ASSESSED VALUATION
• State Fartn 43709 (R71 / 6-09)
,,�,. PresvibeE by DepartmeN a1 Laml Gwemmeiri Firemc
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INSTRUCTIONS:
To 6e filed in person or by mail with the CountyAuditor or Counry Remrder of the county where the piopeRy is IocatedAR Form A;�wrtn:
FiHrrg Dates: 1) Real Property: Must Tle dunng fhe yearlor which the deductlon is soughf. ��� 7� County Auditor
2) Mobile / Manulactumd Hwnes not assessed as Real Properfy Must file dunng the fweNe (12) months
before Ma2h 31 of each year the dedixt'vn is sough[ C.�. County Recorder
See reverse side Ior add'Aronal inshuctions arM qualifications_
nod�rst (ownerw murart buvar - see m_wiraons m reverse sidel . G I BS
T' istrit � Key �wmber / legal desaiption // RemN number Page num6el
ab-� - -ao3-ooi. ��-�'0�8
A�s�sed rahie d rral proper,y as oi ge/ Contraa indebteE'ress unpaid as d Mortgage / ContraY uWehtednass ispaid a d Is Ne app6�ni tha sde
Mmch 1. aa�ait yea 1. aX�P t yeer T1 Aate o( aPP�� �egal a equitaNe mmeY1
V D O V ❑ Yes ❑ No
tt ro, what ts tia l Iwi erxl share of intrvest? If a�med with someare other than spouse. 4d'uate wNh Mnm
IINI12 M
rtrongagee or contract seller �/`� �
of mart�agee a wnUad se0� (nunbv and stree; riry, state. aM LP code)
Name of assignee w otlrer owner or h
Adtlressof �umberantl�
Dces appfifant o.m property in any ot
counry in Indiana? ❑ Y�
Drau(9on auwoved in tlre amount ot
� lM�at Ta�dtg O"str
COUNTYAUDROR
IS ShC PfOPClI`J T QUESLC
❑ Real Roperty ❑
a
Il��'!!�
Dra�rer i\�0.......�..�,.1�......
ca,-� �vo. ......... � �.53
� 84,.��s. � �....
20 _ 20 _ 20 20 _ 2b _ 20 20 _
�rianue W Crnmb Aud'rtw _ Counry Date (rnmM, daY. Y��
C•T
1/ We certify under ihe penalry perjury Nat bove and foregoing infortnatlon is true and mrtect arM that Ihe applicant is a resident of IrMiana arM
awner / conVad buyer of Ihe a oremenUoned operty on date application is fileG.
(awneh Date (monM. daY. Y��)
7 ' ent aOOrsss d app�cant pwm6er an�,�f�ee4 dry, sfate, and LP cotle) � � ��, � —� �-� �
Cy Euly earecuted Power of Attaney or by IC
/ddmss of auUnrtreE pe�son