HomeMy WebLinkAboutMortgage_Ready (4)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
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� FOR DEDUCTION FROM ASSESSED VALUATION
� � State Fortn 43709 (R71 / 6-09)
�' ,�,� % PreuribeE bY DeGartrtrenl of Loml Govemmerit France
File Mark
�IISTRUCTIONS: F � :
To be filed in person w by mail wi[h fhe CountyAuditor or Counry Recorder of the county where the property is I atedI
Fil'mg Dates: 7) Real Property: Must file durirg the }rear /or which the deduclion is sought. unry Audimr
2) Mo6de / Manufactured Homes nof assessed as Real Prope�ly Must file dunng the hveHe (72) rtanfhs unty Recorder
6e(ore lAarch 37 0l each year the deduction rs srnyht. M A R 9 C� ��
See reverse saie !or addiWnal insVuctions end qualifications.
AppG m(ownerarcontra¢_buyer-see�esMCLynsOnmvej�esde) �.•�.�� �
L 1Y (� �C./LC-C�
�
Merch 1. aa�er� Year
If ra, what 5 his I hu exarl
11 name m mmd a CitFerG
Keyrwmbu/1ega�Eescription/ // (iItlSU E�dditdrTiOFiAUD number
✓ �o - /�-0�-303-00/, �is8-�a8 o D d-�
as of Martgag e/ ContraG'uWehtetlness unpaid as of Morigaqe I Contract'uMebtetlness unpaid as of h Ihe applkant tha sole
March 1, artent year date of eppli�ation legal w eQuitade awnM
9'], � o v ❑ Y� ❑ No
ve of intetest? if ovmetl with mmearie other �han spouse. iMicate wdh xiwm
an that o( app6mnt, 6Micate bebv` Is iM property in Question: MnuaDy Assessed
� Real ProPenY ❑ !?�?�!���Y � . . -
Name of rtnrtgagee or mntracl seller
neaRSS or � «�,o-aa sen
Name at assi�ee or oNer nw�rer w Y
AEtlress of a� nee (number aM sm
Does epplimnt am pmperry in any oNer
munry in IMiana?
❑ Yes ❑ No
Detlucfirn appmveE "v� ihe amount of:
20 � 20 —
i stree4 fdy. sfate. ard ZIP code)
age
a,��,P�� 3 P� /a � �
i�/
u yes, what couny? wnat ra�drg oisVicl4
COUNTYAUOROR
20 _ 20 _ 20 _
Counry
I I We certify under the penalty M p�(ury that the
owner I contrad buyer of the atoremeMioned pro
Pnlson auUptaed Ey
of
a��a,
IQa�
q� � �f / V v , V —
20 � 20 _
e arW toregoing infortnatim is we and cortect and that the applipnt is a resident of I�iana aM
on date applicalion is filed.
Date (movah. Eay, Yaa�
IC E7.142-07
person (num6er arM sbeet �'+ry, ste(e, aM
Date (monfi, day, yea�