HomeMy WebLinkAboutMortgage_Smith (32).f�'r STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
;.i� FOR DEDUCTION FROM ASSESSED VALUATION
= Slate Fortn 43709 (RB / 2-07)
'; '' Presrnbed by DeOartmenl of Local Govemment Finance
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INSTRUCTIONS:
To be filed in person or by maii wdh the County Auditor o/ the county whe/e the pioperty is located. �
Filing Dates: 1) Rea/ Property: DuAng the 72 months befae June 17 0/ the year the deduction is to be eRectivg� � p n�,nno
2J Mobila Homes assessed under IC 6-1.1-7: Between January 75 and March 2 0/ the year the d�BiNbor�s 68'8fl6cUve.
See reverse side (w addi6onal instrucfions and quali(cations.
�.' . ' �P— .0�.—�Q '�
as of Mard� 1. nnenl year Martgage I(
curtent year
what is his / her exacl share of interest?
name on
Name
of moM1gagee ar mnUaG seller (number arrd AreeL uty, sfate,
N�mqo(,assigrree a other owner or hold r of mortgage
\7` 4L./,L/I�ld �IZ/ii�
lpddress of assigriee (mmber eM s4ee1, city, 9ate. and
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Does applicanl own properly in any ather
counry in Indiana?
❑Yes ❑ No
Deduction apprwed in the amounl of:
� oq �
P�
1 I We certify'under th
Indiana and owner oi
inatLle (owne/s lull nam
residenl
aulhonzed by duly executed
�� � �. / Y��� Q�
indebledriess unpaid as of March 1, Is tha appfimnt the sde legal u equitade o.meR
❑Yes ❑No
If wmed wilh someone other Ihan spouu, irWiwie wiN whom.
Is the property in Question:
D,Real Property ❑ Mobile Home QC 61.
�.t/CE"70N `f %6 hO
if yes, wna� counry� Whal Tacing Dislricl? Haa Ure deduclion been requested on propeM1y
fp arteM yeaY.+
_ .❑Ye�—�.No
COUNTY AUDROR � Oi �� �S �'Z _
B�
Zo � Zo_ 1 �aa -
,_ Oq- -
of perjury a tlie above and foregoing infortnation is true :
nentioned erty on March 7, 20
�
>ber and sfreet. cdy. stafe. and ZIP code)
Si. %,jQ�NL' EiOti/ , �i�/ 7` �6 �O
vaer of Altnmey w by IC 61.142-.07
Address of aWhwaed persan (numGeraM s7ee4
_ ,� ..
._. �� applicants was I were a residenl o