HomeMy WebLinkAboutMortgage_Richards"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
5_ - FOR DEDUCTION FROM ASSESSED VALUATION
� Srate Fortn 43709 (R71 / 6-09)
,' �«. P25vibed by OeVa��ttl of loral Govemmerrt Fu�ance
INSTRUCTIONS: � a
To 6e h7ed in person w by maD with Ihe CounlyAud'ROr or Counry Recorder o/ the oounry where Ihe property is bcat '' �
Afig Dates: 1) Real Property Musf fde durirg the year /or which tha deducLOn is soughL Coun A�Uttar
2) Ab6de / Manufadured Homes lrot assessed as Real PropeRy: Must file durirg the twelve (f 2) moriths
6efore March 37 ot each year the deduction is sought C���7! ��d�
See 2verse side for addiUonal inshu�clions arM qualifications.
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MarU 1. anerrt 7,ear
If no. what Is ha
If fwrie on remd is Srterent Man that af appOran� uMUate 6eb�r.
mntrad seller
mttt�jagee w mntrad
owner w tioMer ot mortgage
ti�; ffifi,
nmres-_......_..._..�.....�b.�.....�, ,.�.,_�.�,e ,,,,�.��o,,.,,e,
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�-� �j�, �-fJa Ci � ��., , � �j'�
�s unpaid az W Mongage / ContraG'uiEebtedness unpai0 as ol Is the appOfant the sole
Eate of appfi��irn � kpal a epuibde owneR
� � ❑ Yes ❑ No
H wmed with someorre othrllhan . ildrcate with whom
Is e piopercy in puestion: MnuaAyASSesseE
Real ProPertY ❑ �����Y �
. aba� rio� nc ��.�=
� a �o��. � R �1��
counry
r
I/l
Per.ai
�D/D — � 9 S" �
prJSan (numberarW sbeef. �y, state.
: tnis deCUdim Ocen requesteC m pmperty
airrent Y��? ❑ Yes
❑ Ni
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oa� v�,w. aar, r�d
he applinnt is a resident o! Irdiana ard
Date (rtmm. EaY. Yme�
Date (monlh. CaY• Y��