HomeMy WebLinkAboutMortgage_St. Clair (8)""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
�_. ; FOR DEDUCTION FROM ASSESSED VALUATION
State Fartn 43709 (R71 / 609)
�' ,.,. f Preuribed by DepaNnerd of Loml Gm�emrtrerit Frunce
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INSTRUCTIONS:
b be filed in person w 6y mad with tlre CountyAUditor w Counry Recorder o/ the oounry where the property is located. � �� � � U
Ftiny Dates: 1) Real Property: Mus! fife durirg the yearlor which the deductan is wught � County Auditw
2) MobRe /Manufactured Homes not assessed as Real Property: Must file dunng the M1velve (12J monNs ,_, � �,
6etore Ma/ch 31 of each year the deduction is sought e�(f�a,Q� ,�b R��
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See �eversa side lar additional instruct'ons and qual(fiwtions. " "
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a//� KeY 6er / legal desaiGUOn Remrd num6er Page number�
a�''�a-o 03 -��.3, 30o,o�.S� p �/os D
M^xsse0 �ah�e U real p�opaty az of Mortgage / Contraa 4Mehtedness unpaid as of Mortgage I Contract inEebtednrss unpaid az Is Ne epp6canl the sde
Mard� 1, aarrnt year MarU i, nt year tlate of applkation legal w eQuitade ox+reR
O O ❑ Yes ❑ No
It no. what Is h's I her e�racc share ot internsf.+ If owned wiN sameo� other than spouse. indicate with whom
If rwna m ramrE a dfielent Nan Nat af appGCar�t, uidirate Gebw is Ihe property in puestion: MnuaOy A.5e55eE
❑ Real Roperty ❑ amuaMwsse�d ...
Nartre of rtnrtgag mntrarl se4er'//;C�/ X/° `
T �� �li
Pddress W rtnrt�agee or mntraU se�er (nwnbv and sVeet �+H• sbfe. arc
Name af assi�ee n oCcer wmer w Imldu of rtwrt9a5e
v assynee (numeer aM stree4 �: sfa2e,
iKam oM, vroa«ty � anr amw
Ind"ana? ❑ Yes
❑ No
Deduction approueO in tlre amount oi:
2�_ 20_
Signa�turey W� �C�m�mNJ�A�uei�m�r /n�
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I 1 We cerufy u r Ne penalry ot p
owner I contrad buyer of Ne afwer
FWI fesidenl address W
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20
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! the above and
Ipro �� on da
rily, ZIPi
Md� ot aWiorbed person (num6er arM sbee( dty. sbte. antl ZIP mde)
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