HomeMy WebLinkAboutMortgage_Whitehouse"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION �� I��
Slate Form 43709 (R8/ 2-07)
S ur � PracaiDed M DePxrlmmt af Loral Govemmerrt Finance
iNSrRUCnoNS: F�A�Ia 1 4 2009 .
To be filed in person or by mad wdh the CourrtyAuditor o/ tAe couNy wheie the property is bcated.
Fding Dates: 1) Real PropeAy: Dunng the 12 months be(ore June 17 d fhe year the deducSon is to be ef(ec6ve.
. 2) Mobile Hmres assessed'mder fC 61.1-7: Be(ween January 15 and March 2 of the year the deductim is to be e9�.� �� �;
Sae reverse side for addifional instr�c8ions aiM qualificatinns. 0��
Applicam (owner §r�ntracf 6uyar �- see
= i���0 �-�aoi-oot. a3�-�a g
as or r.�arcn �. a,m�� ra,r Monea9e � comrae u,aewedness unpaid as aF A1ar�h �,
wrreNyear �. , ��„��
is his / har ezxf share of iriteresl?
m recwd is diRaent than
matgagee or canl`aG
or mniraC sdler (nwnberand sbeet �i'. s6te. ar'd LP code)
Name of as9gnee or olher oxnar w hdder o( mortga9e
ACdr�s of assignea (number ard sGeel �Y. sfale. ana
Does applirant own yaperty in erry dher
cauNy in Indiara7
❑ Yes � No
Deduction aPPmved in the amounl of:
2b 2b _
Sig�tureof nryAudibr
,��
�
sortieme dher Ihan spouse. indi�ate wiN whom.
��aaa°
`���T�i�� �-,
S/�.v�°'`�
PS���
�Y
w equitabie wmer7
❑Yes ❑No
Is Ne property in ques6m:
❑ R�I Property ❑ Moble Hane pC G7.1
Has ihis �
For airte �� �
- �"`��9 l
2 .��i1
C
t �
I I We cer6fy under the penalry W perjury that fhe above and fonegoing infomw6on is We and mrtect and thal the app
Indiana and owner oi the atwementimed property on March 1, 20
�� (p� e (owne/s hdl name) /� �. h
i1 �} .. _ _. .-, _.-, , . �J� k- 1 !-.. . 11� V
address
aWhor¢eC by
stree4 ciry; stafe. and LP mCe)
�
ttamey or by IC 61.142-.07
person (num6erarMSheel.rdy.sfate.
Oale (monfh. daY• Y��I