HomeMy WebLinkAboutMortgage_Woods (4)^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ • FOR DEDUCTION FROM ASSESSED VALUATION
� • State Fortn 43709 (R11 / 609)
'� p`esrfib¢tl by �epartmeM o1 Local Govemmanl France
File Mark
iNSTRUCTIONS: � �
To be filed in person w 6y mail wifh the CountyAudRw or Counry Recorder o! the county where the property is �
Filing Dates: 7) Real Property Must file during the year (or which the deduction is sought ry ditor
2) Mobde / Manufactured Homes rrot assessed as Real Pmperty Musf fiie dunng the hveNe (72) mon s
6e/ore Ma�ch 31 0( each year the deduction is sought f'I County Retorder
See reverse side fa additional inswcUons arM qualifications. J U
Applaant(ownerarmntr�Ub r-s9eresuictiwssm�versevCe) n n C.�.M..�'�:..
i real p�apHtt�s d
Y�
his / her exaG sliare of interesl?
If name m remd'a NRr1mt than
Nam¢ W rnortgaqee or cmtrad seller
legal dcscn Fwr
. � � � �
u�dicate Eeb�r.
Atldress of mort9a9ce or mntracc seAer ( numbrl and shae4 cM state,
Name o( assig�e or oNer awner m naaer o� mor[gage
AdE2ss oi assrynee (number aM st2et ctiy. s+ate, and
Does applicant wm property in any oNer
�'������� ❑ Yes ❑ No
DeEupion apprwed hi Na amouni of:
20 _ 20
Sig�Wre W Ca�mbAWitw
�ness� unoaiE as
Z/Pcotle)
If yes. what wunq?
�o�
20 _ 20
��
rc �,aa �m ��� wn� ma� s�e.
)N CO�J I�AU
unPaiE as d Is Ihe si
�a
Y� u No
is Me property in Question: MnuaOy Assessed
❑ Real P`oPertY � �!��Y�
Dra���er 1�o...ao�a.......
Card N0. ... a��.�.�.........
la��t-1�3.qy
20_ � 20_
��
stetl m piopelty
Yes ❑ No
20 _
yea�
I I We certify under the penalry ot perjury tt�at ihe a6ove arW (oregoing infortnation is We and wrtect arM Nat ihe applirant is a resident of Indiana arW
owner I tract buyer of the aforementioned property on date applicatlon is filed.
,..�«� ...,., r� s,n.v,nrw� � . � Date (montb. CaY• YsaA
authu'ved oerson
riry, state, ard
51a(e, and Z!P oode)
— . - I bate (monfh, daY• Yea�)