HomeMy WebLinkAboutMortgage_Rinehart (2),�.
^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
__,_ • FOR DEDUCTION FROM ASSESSED VALUATION
•. $late Fwm 437W (R71 / 6-09)
�` � � P�esaibed by DePartmeN of Local GovemrtreM Finance �j �� J
� �� ` File Mark
INSTRUCTIONS:
Fwm Aed wiN:
To 6e filed in permn or by mad vdth the CountyAuditor or Counry Recortler o/ the oounry where the,.�QP� i1y,{' ted.
Filirrg Dates: i) Real Pmperty: Must file dunrn� the year (or which Ne deducLOn is wughG S E Y 1 y [� � Counry Aud"rtor
2) Mo6Be /Manufactured Homes rrot assessed as Real Properly: Must fiIe dunng the hveNe (12J months /�
before March 31 of each year the deduction is sought. C���-R � Counry Recorder
See reverse side ( r additional ins�rucUOns antl qua ' catior
App5mnt (o mntract 6uye�- see reF '
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T ' Key /legaitlescripti
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raNedrealR�Yasof ge /COnt
Mard� .wrtn[7� 1,a�rteni
If no, what a his / t� eraC share of interest?
If fume on �emN's Qiffsem tlun ttat of aPP��t uMicate bebw:
Name oi ntut�agee «mntr'aG Se9er a
.ao'-oa y
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unpaid as d MMgage / Contraa uMehtedness unpaid as of Is Ihe ePP��t the sole
Eata of appOCation kgal w epuitade ameY!
�� ❑ Yes ❑ No
If wmed vriN someorre other ttan spouse, i�Micate wilh wlwm
Is tM praperty in puestian: MnuaAy Asses5e0
� PJlfltl3l�yllSSessed
t f�C3� PfOpCRJI
Mob�le Flarie (IC 61.1=�
state. a/{N ZIP code)
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Card NO%. .. �'.,,�\.�....... ���nn wna�T��o��«z r�a e°�;�,e�����a�,o�r
I JY� �U. (JU ❑ Yes ❑ Na
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