HomeMy WebLinkAboutMortgage_Sheridan"'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
,__ = FOR DEDUCTION FROM ASSESSED VALUATION
. . • Stale Form 43709 (R11 / 6-09)
S � P2sv�bed by Department of Local Govemmenl Fu�arxe
ie
wsmucnoNS: wtM
To be filed in person w by mail wifh the CountyAUditor or Counry Recorder of Ne counry whele the property is located. N � L u�9
Filirg Dates: 7) Real Proparty. Musf file dunng [he }rear (or which the deduction is wugh[. � Counry Auditor
2) Mobile / Manufactured Homes not assessed as Real Prnperty MuSf h7e duAng the fweNe (72J rtwnths
before March 31 of each year the deduclion is sought a� ry Remrder
See reverse side /or additional instructions and quali�cations. �
MP�nt (owneror tanvad b r-}ee restlirtpnc m reirerse vde)
T- Distrrcl Key n�mber / legal tlesaiplim RemN number Page numorl
n,��...c.t�'c�-� 210-/,2_18-3oy-ooa.la3G-oa-B Do`1 5573
Atsessed veWe d mal pmperry az of Mo e/ ContraG "uWe6tedn�s unpaid a of Mortgage / Contrarl'vMebteEness �mpaid a d Is Ne apprirant ihe sole
Memh 1, ar�ent year Ma , ra7irtem yeer date ot aOP��� legal w eWi�de owneR
I ODD ❑Yes ❑No
If no, what a ha ! her e�ct share ot intcrestt If wmed vriN someone other than spouse, indicate with whom
tl runre m 2cwd is d�fermt than Nat of aPp6mn, ind'wate bebw Is pmperty in puestion: Mnua%PSSessed
�aem ❑ ��N� . . _
Name of nnrtgagee or convact u4er
Address of mortgagee or contratl seller (number aM snee4 cily, sta�.
Name ot assiryiee w othei owner or hdder of mortgage
ray, stare, antl ZIP cotle)
li�ant own pmperty in any ot�er I If yes. �Miat munty.�
Indana?
❑ Yes ❑ No
DeEucoon appmved in the amount of:
20 20 _
SignanneorCounNAUaimr l
I I We ce" under ihe penalry of
owner 1 contracl buyer of Ne afon
Sig�aWre(owne hNrwne)
���
FW resident addrass of appfxant (numbe
2�•S S ,*nsN i�
Person authafaed by tluty executed Pow
�
�'
)UNTV AUD:. _.
2�Counry
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Dra►ti•er 1Vp... �
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Card ��p ..... �.J�, S'%3...... °
� 77is51. °-� —
p- �.r �
Date (month, daY• Y��
20
the above arW foregoing infortnalion is We and correct arW Nat the applinnt is a res'Went of IrMiana arM
properry on date apD���mn is filed.
Date (month. deY. Y��
and strec4 aN, s+ata, entl LP m
p2%.�[EroJ
' of Attort�ey or Cy IC 61.1-12-0]
ot authw'aed person (number arN sLeet, city. sfate,