HomeMy WebLinkAboutMortgage_Arnett (3)k
�
"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear �
._ � FOR DEDUCTION FROM ASSESSED VALUATION �
• Sfate Form 43709 (R71 / 6-09)
�' ,�,� � Presmbed by DepaNrrent of Loral GovemrtreiLL Firiantt
File Mark
INSTRUCTIONS:
To be filed in person w by mail wifh the CountyAUditor o� County Reco�der of fhe county wheie [he property is located. 0� F �
Pifirg Dafes: 1) Real Pmperty: Must file dunng Ihe year /o� which the deduction is soughL Coun Auditor
2) Mobde / Manufactured Homes rrot assessed as Real Property: Must file during the hvelve (12) months C� � ty
betore March 31 of each year the deduction is sought. � �vH Recorde�
Seereversasideloradtlitionalinstructionsandqualifications. GIBSON C i OR
Apprt�m (ownera crnuarl6uyer - see iysfi'r.tiorqm reverse sitle) ..
Ta ustriG � Key number / legal desaiption Recoid numbr! Pa9e number
-/ -oP-/o3 -00/.35.�-0.�8 0/�- 58a
ralue af r�l paperty az d Mor�gage/ Contrau 4de6tedness unpaid a of MMgage / Con7aC hMebtedness unDaid as of Is Ihe aPP�� the sde
MarM 7. amart year Martl� 1. artent yeer aate at appGcatm legal ar equitade axnrfl
$ Q ❑ Yes ❑ No
11 m, what ts ha I twi e�U share of infeJesi? If awned xT,h someone oCre than spouse.'vid'�cate wXh wMm
tt name m recwE a SMemnt fhan that ot aPP��. uidicate Debw: Is Ihe ProPeM in Ouesiion: Mnuaoy Assessed
I ProPeKY ❑ ���Y �
Modle Hane IC 61.7-7
Name o( nrmgagee or contra�a seAer -' �
Address of nwrtgagee a cantrac� se0er (num6er ara sbeet �y, sbte. aM LP code)
Name of assignee w oMu ovmer or hdder o( rtprtgage
�a�
Does avW�'ant own woP�Y
counryinlndana? r
20
20
�t�.�.
of
I I We certify under the penalry
owner / wntraa buyer of the a
�
/ddress of auNOraetl person
that
2� _
sfa(&
couNrr auorrot
a .... �
Dra�vcr NO.. °�v 1.....
35� '
Card i�0. ...... ^•� • •
....... _
� $��33,cx� —
zo_ � - —
Counry
� _ i zo
Date (monN, daY.
e and toregoing infortnalion is true and correa arM that the applicant is a resident o( Indiana arM
on date application is filed.
Date (month, day, ysa�
a�
�Y ��