HomeMy WebLinkAboutMortgage_Nesbitt"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
__ . FOR DEDUCTION FROM ASSESSED VALUATION
• State Fortn 03709 (R71 / 609)
�' r PteSCribed Ey Department o( Latal Govemmenl Fillance
,w.
File a
wsrRUCnoNS:
To be filed in person w by mail with tha CountyAudiror or Counry Recorder of the couniy whele the properry is located.
Fi/irg Dates: 1) Real Pmperty Must file dunng the }rea� for which fhe deductlon is wught.
2) Mo6�7e / ManufaUured Homes not assessed as Real Property: Must file danng the twefve (72) months
before March 31 of each year the deduction is sovght.
See reverse side (or additional instnxGons aM qualifications. G
eC rdWe a rea popelty as
t. armnt year
what is lus I Irer e�1 shara OI inirRSt?
artent )mar
11 nartg on remtl s dMerent Nan ihat of applloni, mdi�ate below.
Name of mortgagce m m�tract seoer
«cono-aa
owner w
state,
Address ol asvgnee (numberaM avee4 u�y. s/ete, arM ZIP potle)
rs apptica�LL wvn P�PeRY in any ahei
intyinlnEiana? r
❑ Yes L
tluction approved m tice amount of.
20 20
uunae of Camb a�tlnor
I I We ceNfy under Ne penalry of p
owner I mntrad buyer oi ihe aforer
az
It axned with someane oNer Nan spouse. indxate with wMm
DI'AWCI' �O...v�OO�
C:ll"(1 ��. ....I.���..........
CounN
Auditor
w cquitade ame�+
❑ Yes ❑ No
Is Me property in Questim: Mnuauy nssessetl
� Real PNPenY ❑ %�^^��Y �
Fias
tort
�
oaee (rtmu�. ear r��
� P�Y
20
Mat the above arW faregoing infortnation is we and cortec[ arM ihat the applipnt is a resident of IrWiana and
ned property on date applicatlon is filed.
esew[etl Pwer af AttaneY � bY IC G7.1-12-0.7
Mdress ot aNhassed person (numberarM stree; riry, stafe,