HomeMy WebLinkAboutMortgage_Atkinson"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__., + FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Fom 43709 (R71 / 6-09)
,,� � Presmbe0 by Departmerd of Local Govemment Fuance
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INSTRUCTIONS: w�i�ty
To be filed in person or by mail witA the CouniyAUditor or Counry Reco�der of the county where the property is located. F J C f 1� 2 Z� �
FiNrg Dates: 7) Real Prvperty: Must fiJe dunng the year for which the deduction is sought Counry Au imr
2J AAo6ile / Manufactumd Homes rrot assessed as Real Property Must file dunng the hvelve (12) months r
6elore March 31 of each year the deduction is soughG "'--Rewrder
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See reversa side fnr adtlitional instructions and qualifirafions. GIB
MP�9�(oyJwrorwntrarl6uyer-seel4y+l����@���) �
11 ro. what's his / her e� share o( ii
It rwre on remd is NRUent Nan iha
Name of rtrorigagee or contrar2 seller
nae� or ��nya�ee � �,o-�n �o
Name of assignee a oNer owner or Y
Ade�ess of assignee (number ard sfi
ba/�ega ewiption
�J — 2� - 0 /. �
RR'�•?�
ga / Contrafl iMehtetlr�s unpaitl as W Mor�gage I ConYact i�ebtedness unpaid as of Is Ihe ePP��t Ne sNe
Ma 1, wrtent year date of eppOCation kgal w eQUitade oxnM
�� ❑ Yes ❑ No
It owned wi'S snmeone other ihan sW�se. iMiqte Wih wlrom
sbte,
own property in any oiher
a?
❑ Yes ❑ No
DeducGrn appmved'v� ihe amount ot
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eeL city, s+a . n codej
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ZIPCOde)
If yes, what munt�/T What Tadr�[j Di
COUNTYAUDROR
20 _ � 20 � 20 _
orCamNnwrtw
I/ We certify under ihe penaly of perjury that Uie abo�
owner / mntrad buyer of the aforementioned property
�reyre (p� er's hN rame) i0 /7 I L •
i�
Is tl�e P�PertY in 9ues6on:
�Real PmPeM ❑ ?
Nas Nis deeuction been reVUested m O�opertY
for arrem yea(.� ❑ Y� ❑
a�o�a
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Card NO. ....I.�.�.�..0.........
I��/�YV`�'Uv
� Fu0 resiEeni aONes ot appficant (num er antl stree4 ary, state, aM LP cotle)
' 70G 3 Zr/. '
Person auNaaed Dy duty exeated Power of Attort�ey w by IC E7.1-12-0.7
/ddressofaWrof'vedper:vn (numberaMStrec;dry,slate,aMLPCOde)
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20
dinnt is a resident of Indiana and
mte (rtmfi. daY. Wa�
�y ,�eeA
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