HomeMy WebLinkAboutMortgage_Walker (7).+�'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u To ip Year
;;., FOR DEDUCTION FROM ASSESSED VALUATION
' SIa1e Fwm 43709 (R8/ 2�07)
�6�� `� Presaibed by Deparimenl of Lacal Govemmenl finance M R 1 7 2009
a�
File Mark
INSTRUCTIONS: `7-n � ��
To 6e filed in person or by mail with the County Auditor o! fAe county wiiere the property is located. � 0��
Fding Dates: 7) Real Property: Dudn9 the tt months before June if o/the year fhe deduc6on is fo be e7fec6ve. �BGg� �����y AUDITOR
2J Mobile Homes assessed under IC 6-iJJ: Behveen January 75 end March 2 o/the year the deduc on3 e.
See reverse side (a addifional instluctions arM qualificafions.
Applican vmer or mnhad ei - s e ie4ntG'ons erse sidej ' �
/
Y
T' DisUitl Key number / legal desaiption Rem�d number Page number
.: ,(-. / a- o?_-/o�< - o.o a. 8: 9. - o a. b' 9�! (o
Assessed vdue of real properly as d March 1, aurent ymr Akutpage / Contreq indebtedness unpaid as of March 1, Is Ne appfipnt e sde legal a equifade rnme(
anenl year n .
/ � � ❑Yes ❑ No
`b, whai is his I her ecad share of irrteresl? If ownad wilh someone other Ihan spouse, indicate with whom.
If name m recmd is different than Ihat of applicant, iiWiqle beloa:
Name of mortgagee or cantract seller �
,
Address of mortgagee or mnUact saller (num6er aM shee(. aty, sfa(e.
Name af assignee a ofner owner or hdtler of mortgaga
Address of asvgree (numbe� sM sGeef, tity, stafe. eM ZIP oode)
Does applicant own property in any oiher
cwnry in Indiana?
❑ Yes ❑ No
amount af:
� � �a
If yes,
zo _
Is ihe property in queslion:
❑ Real Prooertv ❑ Moble Home OC 61.1
. � . ��c. K��e�_a y�o,�_sHQ� -
d ZlPCOde)
I�I�o.QR�I
COUNTYAUDROR
.�'�
Coumy
09- 9s��
�UicIT nw �
far airrent yeaR
20 20
�ate (m
sd on property
❑Yes ❑No
20
I I We certify un1�r the penalry of p�ury that the above and foregoing intortnaUOn is true and corteU and tliat ihe applican}s was ! were a resident af
Indiana and owf�er of the aforementioned property on March 7, 20
inptwe�(owneYs lull name) � . Dale /month. day. Y�A
by duly execvled Power of Attomey or by
Address of aulhor¢ed person (number en0 sbeet dty. slete, aM ZIP mOe)
Date (month, day, yea�