HomeMy WebLinkAboutMortgage_Parker.� q� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNES , T ip Year
,,..,._ ? FOR DEDUCTION FROM ASSESSED VALUATION
x Slale Fortn 43709 (R8/ 2-07)
��; � Presoibetl by Department of Lacal Govemmenl Finance
File Mark
INSTRUCTIONS:
To be filed in person or by marl wifh the CountyAuditor o/ the county where the propeAy is bcated. '-7� �
Pding Dafes: 7J Real Pooperty: Dunng the 72 months belore June 11 0/ the year the deducGOn is to be effec6ve/�'�
2) Mobile Harres assessed under IC 6-1.7-7: BeMeen January 15 and March 2 0l the year th�ded�ftp�q�e � R
See 2verse side /a additional insWctions and qualificafions. G 30
Applicant (owneror mnfrad buyei-see iesiric{ieqs on reverse si0e)
�
�/�/� eP� rYr� � oc �o - i d
ralue of rP.al popeM1y as of Marrh 7. arrent year
is h's I her exacl share af iirieresl?
-..y°s_��a.U�/ oa
age I ConUad iMebtedness unpaw as a March 1,
on reard is different Uian I�a� of applican4 ��inle below:
Name of nqrtgagee or canVacl seller
w�h
Address of rtartgagee w oonlracl seller (number and street dty, sfafe, aM ZIP corla)
Name of assigriee u dher a.vner w hdder of mar�gage �
�
Address of assignee (number and sfreet, city, stafe. and ZIP code)
Dces appliwM own propeny in any other
caunry in Ind'una7
- ❑ Yes ❑ No
approved in the amounl of:
���i��'i�
Ramrd number
Is Ihe appticanl the sde legal a equf�able wme/
❑ Yes ❑ No
spouse. iMicate wiN whom.
property in question:
�I Pioperty ❑ Mobile Home QC 61.7-7)
yes, whal counryt '�� .� ,�7i�j,}'` ad on popeAy
'i '• ��j`�/�pr.�� �Q.C,�,�iLJ0�20�. Yes ❑No
, C. (,( .
/ ' '
20 20 � [U
day, yea�
20 _
1 I We certify under the penalry oi perjury �hat the above and foregoing infomwtion is true and correc[ and Ihat ihe applipnts was ! were a resident of
Indiana and ow�er oT the aforementioned propeAy on March 7, 20
ma� wn s rwine� i oa+e (�m. ear. r��
of
P�rson aulhorrzed by duty en
Address of aWlior¢ed pe�san
(num6er and sGeet. ci(y. s[ate. aM ootle)
�/I1'JN Sfi fl /NC Y�o�..J L�✓ �L
ed Power of fLLiwney w by IC 61.1-12-.07 '
sfafe, arM LP mde)
Date (rtronlM1. day.Y��)