HomeMy WebLinkAboutMortgage_Willis.�°•n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
r,, .: k FOR DEDUCTION FROM ASSESSED VALUATION
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Stale Form 43709 (RB! 2-07) y � �
�6�,: ' Presaibed by Departmenl of Local Govemment Finance �; �
File Ma'
To befi ed�n person or by mail wdh the CountyAuditor o/ the county whe/e Ne property is located. � �^� 0�� (��9
Filing Dates: 7) Real Property: Dunng lhe 72 months 6e(ore June 17 of the year the daduction is to be elfactive.
2) Mobile Homes assessed under IC 6-iJ-7: BQfween January 75 and March 2 0l fhe year the ded s to be efrecbve.
See reverse side 7w addi6onal instroctpns arrd qualifiwfions. _ �ati, ,Q�,
Applicanl (owner w mntrdd buyer -
Key numbet I
ralue ot real prop�+ty as oF Matdi 1. tufenl year
of interest?
If name on recwd is diReren� �han that of applicant, intlinte Oelow:
Name of morlgagee or contract seller
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Address af mortgagea w mniract seller (number and sfreef, tity, sta(e. arrd LP crode)
Name of assignce or dher wrrrer w hdder of martgege
Atltlress of assi9nee (numbrs arM sVeeL dty. slste. and ZIP cotle)
Dces applicanf own property in any atha If yes, wliat
counry in Indiana? .
❑Yes ❑ No
f�
Deduction app {
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a°O9_
Dra�vei• NO.......:r�o°Z..
�•� Carcl NO . .....................
SyraWre of C';
i .
i
I/Wecer.�,._.__ _ _
Indiana and owner of Ne aforementimed property rn Marcn �i, �o
iS' wre (owners /ul/ name) � � _
city. stele. aM ZlP code)
S/�t%✓i ..f"'LJ,� -U4/!��
by duly exe�vted Power of Alinmey or by
Atlaress ot aultwraed persm (numbe. and streef, ary. stete. aM ZIP wde)
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7(D-b a �
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Remrd number I Paae number
wilh someme olher Ihan spouse, �cate
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�s me v�m
❑ Real Prop
��� � ��ae �n
❑ Yes ❑ No
❑ Mobile Home pC G7.1
Has Ihis dedudion been requested on poperty
fw ainent yFan
❑ Yes ❑ No
so Zo
Date (month, tlay. yeaA
ig infwmaUOn is true and corred and thal the applicants was /�were a resident of
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