HomeMy WebLinkAboutMortgage_Satkamp"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun i
__ _= FOR DEDUCTION FROM ASSESSED VALUATION
• • Stale Fwm 43709 (R71 / 6-09)
�' ,�,� ` Presa�bed by Oepanmerd of Lowl GwemrtreM Firence
File Merk� l.c 201)
�INSTRUCTIONS: U� �
Form f�ed wCith:
To 6e filed in person or by mail with the CounlyAUditor or Counry Recorder of the county where the pmperty is bcated. �O� n� " V
Filing Dafes: 7J Real Property Must �le dunng fhe year (or which the deducfion is mughf. � unry Au
2) Mo6de / Manufectuled Homes �at assessed as Real Property: Must file dunng the tweNe (12J months
6efore March 37 of each year the deductan is sought. G�D�N'01��(JDI R
See reverse side (or additional insfimcliwis and qualfications.
MWti^� (ownerD•S�^��=A'N'��' SPAre�➢C6onY°P �everse siie) / � .
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�w, whal Is his I her exarl shara ot iNemst?
— — civ —vv —
� Cantrarl indebtednass unpaid as U Mortgage.
urtent Y� date of aVl
tl o�vrred wiN sorne[
If �rrre m remftl is d'rfferent Nan ihat o( aDW�t, i�Mirate bebw
Name W mMgagee m m�traU seller
Address of rtar4)agee or mntrad sWU (numbr�?Td streel, cdy. smte. �fd LP code)
Name ol assignee or dher owner ar hdder of mortgage
Mtlress oi as9gnee (nvmber aM sneef, ciry. slate. antl LP ootle)
Oces epptitam wm property in any ather 11 yes. what munty?
wunty in InOiana? r-� ._ r-� .. -
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; �mpaid as d Is tl�e appGOnt
legal w equitad
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"u�S¢ate with vrtiom
�e propefty in puesUOn: Mnually As5e55eC
Real Property Q Mnually AssesSed
AAodle Fiort�e fiC 6
— I What Tad�g DisU'x17 Ha5 Nis Cetlurlian Eeen reques�ed an praputy
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I/ We certi(y under ihe penalry of perjury ihat ihe above arW (oregoing in(ortnaGon is We and cortecl arM that Me applipnt is a resident of Indiana and
owner ntracl buyer of e� ed property on date applinlion is filed.
sare ��oi�r�ers rr��me5 . l /I oate (monm, dar, r��)
o( Anamey m by
Pddress of autha'vcd Per:.on (numDeraM sneet. tlry, state,
Dale (monlA. daY. 3Ta�I