HomeMy WebLinkAboutMortgage_Sollman (10)• --- -- instrunent �
:� _- _- — - — -- --- — - 20L200004842 �
.�",:�A STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ship Year �
<.,.. ; FOR DEDUCTION FROM ASSESSED VALUATION -
State Fortn d3709 (R71 / 6-09)
°�—�� Prescnbed Cy Depanment of Loral Govemment Financa
F'Ie Mark
INSTRUCTIONS:
To 6e filed in person or by maiL Form file wi ��:
Filing Dates: 7) Real Property: Musf be complefed and dafed in fhe calendar year lor which fhe deduction is sought.
Must be filed wifh the Counry Auditor or Counry Recorder o/ (he wunry where fhe pmperty is Ixated C� � uditor
on or betora January 5 of fhe immadiately succeedinq calendar year. � C corder
2) Mo6ile /Manulactured Homes not assessed as Real Property: Musf file wifh fhe CountyAuditor o/theG18
county where the propeRy is Ixafed dunng (he rtveNe (12) monNs before Maich 37 ot each year the
tletluction is sought.
See reverse side tor addifional instmctlons and Qualifications.
District
1 rdue W real woPerY as of
rurtent yeat
If no, what is his I her e[ad share
Aaaress of m)ortg.a.g�ee or mntract setler
:` • l � �
Name of assignee or oNer owner or hd
����, �
�-
numDer / legal Geuription
t�- 23-IC„-►c
IMortgage / Convaa u
March 1, curtant year
sveeC crry, state,
rtartgage
�• ��(YYt0.v�
Remrtl numd
•��-l. �a'
Igage / Con•,rdG indebtedness unpaitl as ol
iofappGcation �
, � �va,�c�. o
someone oNer than spouse, indifate with wt
❑ No
perty in que5tion: Mnualty Assessed
Property ❑ MnualyASSessed
Mobile Home (IC 6
Does appticant own property in any olhar If yes, whal munry) Wl�at Taxing DistriU? Has Nis detludion been rapuesteC on property
oounty in Indiana? �w cunent yeaR
� Yes No ❑ Yes ❑ No