HomeMy WebLinkAboutMortgage_Wright (11).> °°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hip ea
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R8! 2-07)
�' ,ew � Presoibed by Departmenl d Local Govemmrnt Finance
File Mark
lNSTRUCTIONS: �—.
To be filed in person or by mail with the CounfyAvditor o( the county where the pioperty is bcated. �� ,Q �
Fding Dates: 1) Real Property: Dunng the 72 rtronths before June f1 of fhe year the deduction is to be elfec5ve.
2) Mo6ile Homes assessed unde` IC Sf. f-7: Befween January 15 and March 2 of fhe year the deduction is fo��Ofi�(gpUNTY AUDITOR
See /everse side /w addifbnal insfrucSons arrd qualifications.
(owner or wn4ad buy�� 2Nrictions m reverse see) ^ , )
(y l%`i
griG . Key number / i I descnption
- / - - 03 -DOd, �s - c� a �
value of real pop�rty as of Mamh 1. arrent y�r MMga9e / Contracl indebledness unpaid as of March 1,
°'°�, �`ld� �3 Y 7
tl is his / ha ezacl share of iMerest? If wmed with sorr�eane ott
It reme on recwd is diRaent Ihan Ihal of applicant ��dipte 6elow:
Name of mortgagee or conlraG seller K /J � —1_
Address o(moM9agee or conUad selter (numberaM sGeet. tity, state, arW ZlPcode)
Name af asvgnee a Wtier owner w hdder ot morigage
AdOress of
Dces appli
cauMy in Ir
state. and ZIP mde)
property in arry oNer If yes,
❑Yes ❑ No
Deduction apprwed in the
2b
Sy�ture
�� I �
cour+Tr
�
Remrd num Page n brl
a ao b' a�o �
�s Ihe appGCa��u,e swe �egal «eGui+ade o�men
❑Yes ❑ No
in spouse, irWicale with wham.
�he praperty in quesUon:
Real Properly ❑ Mobile Horne QC 61.1 �
"� ' Dra�ver N0_
aljG.�;. �$'D�
auo�. card;�`Q: .. `.\3��•ov ...
1'��,�a ����i�a,
_ � 20 _ ' 20
Dale (mmN, day, yea�
on poperty
5 ❑ NO
20
I! We �rtify under the penally of perjury Uiat the above and foregoing infom�ation is true and corted and that the applicants was / were a resident of
Indiana and ovmer of the afwementioned property on March 7, 20
\ le �^.vne/s !WI name) Dale (rrpnth, daY. Y��)
1 '1 _ � _ �
Of AlIIX112Y IX by IC.
BII��IOfRCd pP15011 �(�IIT62ldlI�Si2C[ LI�. S�diE,
QaY, Y��)