HomeMy WebLinkAboutMortgage_Vermillion (2)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ip ��
FOR DEDUCTION FROM ASSESSED VALUATION
State Fortn 43709 (R71 / 6-09)
�` ,,,� Resrn�betl M Department ot Lual GovemmeM Frwce
INSTRUCTIONS:
F'�5�`"2 6 2012
Form fiietl with:
To 6e filed in person or by mail with fhe CounryA�ditor or Counry RecoNer o! fhe County whe2 the property is located. � �
Fifing Dates: 1J Real Property Must file durirg the year for which Ne deduction is sought. � Counry uditor
2) Mo6�7e / Manufactured Homes rrot assessed as Real Property: Must fiIe dunng the hvelve (72) months C�unNR \
before March 31 ofeach yearNe deduclion is srought. BS CUUN �Y ITOR
See reverse side for aUdifional insVUCUons arM qualfications.
Ap�m�erorpontrarl6 ,-searesLir�vumreve+sesid� � ' N li.��_ . .. � i // .. ✓�„ /�
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AsscsseC ralue d rral paperty as of Mo�qage / ContraU intle6tetlness unpaid az of Mortgage I Contrac
MarU� 7, aarent year Mamh 1, airtent yrnr Eate of appliptbn
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�� „�._�.n+at a his / her e�C share o( interest? 1/ awned with mmeo�re dhei
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COUNTVAUDROR
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iMebcetlness unpaid as a! Is Ne appfrcant Ne sde
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3 �% /»`1 ❑ Yes ❑ No
VeM in Vues6on: MnuaOY Assessed
�venv ❑a,nnuanyassessed
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Flas Iha aedudon eeen rea�estea a, vropertr
ror wnenc r��' r, - - ^
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(monN. daY• Y��)
and foregoing infortnalion is We and correct aM that the apP��mnt is a resident of IrWiana arM
n date appiiration is filed.
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