HomeMy WebLinkAboutMortgage_Pollock"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coum
_ - FOR DEDUCTION FROM ASSESSED VALUATION
State Form 43709 (Rt t/ 6-09)
` � PresaiEed by DeparimeN of Loml Gavemrtrerit Finarrc
1NSTRUCTIONS:
b ba �ted in person or by mail wifh the CountyAUditw or Counry Recorder o/ fhe tounry where the property is .
Fil'mg Dates: i) Real Property: Must file dunng the year /or which the deducUon is sought.
2) Mobde / Manulactured Homes not assessed as Real Property: Musf file dunng the fweNe (12) months
before Ma�ch 37 of each yEar the deduclion is sougAt.
See reverse side /or addilional inshuctp�ms arM qualificatbns. �� �
�� d rea� v�venr as m
a�rent yrar
ro.
iwne m
Key �a¢riDu
Oi YIfPlPSI?
Mortgage/
Me(M 7. P
Addres d rtnrt9agee w mntraU se0er (number aM sveeL
Name of zssiNea w aher wmu or hdder a4 mrtgage
=la-a � 3o/-b�l� �s o-o
ntrsa 4ide6te0n�s unpaid as of Morigage / Contrad indehte
'�'�L-i !7 �] r' date o( aPP��
AEEress of assignee (num6erantl sveet �tiY• �am. end LP totle)
property in any o1M1
°� PDu- DG<� CN/}N D�i4
do�o-�91,9
�
Wyy,Auditnr
County Remder
unpaM as of Is Ne eppliont Ne sde
kgal w epuitable wme(7
❑ Yes ❑ No
tl awned wiM sortieona dhcr C�an spouse. "udicate witli wfwm
k tlre PbPertY in QueSfion: Mtwelly Asessetl
❑ Real RoPenY ❑ Mnually Ass�ed
LP coda)
ste0 on piaperty
Yes ❑ No
COUNTYAUDROR
zo � zo— � �— t �—
,� ��ry �,� ��. �� � 3 _I (�
�D.c,c �
I � foregoing infortnation is We and correcl and that the applipnt is a resident of Irdiana and
wmer � mntraa Duyeiof the afaeme`rtionad property on date appiicabon is fited.
t l �(oYYI frY1� ,. s� Yill\ l � 1(ti� l� Date (monM. EaY. Yge�)
I�-3- 10
Peison auUro�,d Gy dWy exewted Power olAttGmeY � q' IC 61.7-12-0.7
Derson (numMr aM sbee[ �Y• slate.
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