HomeMy WebLinkAboutMortgage_Nixon"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__,_ = FOR DEDUCTION FROM ASSESSED VALUATION
• Slate Fwm 43709 (R11 / 6-09)
`,,,, � Presaf6e0 by DepartrtreM af Laal GwemmeM Fu�ance
� g ile
wsrRUCnoNS: 9
To 6e filed in person w by mail with the CountyAuditor or Counry Recorder o/ the county where the pioperty is 1 1
Filirg Dates: 7) Real Pioparty: Must file dunng the year for which fhe deduclion is sought � COotunty Auditnr
�1 �fore March 31 o/each yrarthe deduction is sougM ��� Mus! file dunng the M1veNe (12J months O T[t'-1 ZW�nty Recordu
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See reverse side !nr addiGOnaf instructtons and qualifrcafions.
Marrh 7, artMt yrar
If ra, what is his /
tt(wrie m recortl is ddFermt lhan thal of appOrant, uMifate below:
Name oi mortgagee or mnVad seller
,3o/-000. a �5!- o �8 �����
S irdebteCnass unpaitl as U Mwigage I ConYa� iMehtetlness unpaiE a d
ar Catc of eppfKation
mntrad seAer (n�nnDar entl sbee4 �QY, sb�e.
�
spouse,
� Page numb�i
is Ihe appfivnl Ne sole
legal or equitade wmM
n Yes ❑ Na
Is tM P�GenY in 4ues5rn: MmisRy Assessed
�ealFhopeAY QlvmuallYA�sed
MoMle Fbme (IC 61.
r
(nvmber end shee4 �Y. �. � LP cotle)
�%'k..(',n/ �i\.% �i
Ty in any oNer I It yes, what munl�?
❑ Yes ❑ No
,v��,��
zo
/ d o %� �
Whal Ta�dig D'¢tricl?
zo i zo
Has �his Aetlutlian been reQUesteE m praperty
twwrtentyeaR ..❑ Yes _ ❑.No
Nr�ar� ��A�.�s a
,,��.A v
/ J-3�1O
I I We certify u�er Ne penalry of perjury th�4he above regoing infortnalion is We and mrzec[ arW that the appirant is a resi0ent of I�iana arW
owner I contract buyer of the aforementloned property o d e appliralion is filed.
Sig�ature (owne/s /uU.n/ame) Date (nnr#h, EaY. yaa�
� .N
. u0 msitlent adtlmss of appfrcant (number antl shee4 btY. slate, and LP mtle)
908 'e . EvR�.rs �K�.xcr�.� ...� ti17� �o
Person auUrorized Gy duy ezewted Power of Attomey or by IC Gt.1-12-0.7 Date (monN. Qay, yeaA
Pddmss of authoraed persan (number and sbeef, cily. state.