HomeMy WebLinkAboutMortgage_Cutsinger (6)'^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun a nshi Ye �
� FOR DEDUCTION FROM ASSESSED VALUATION
�• Sfate Fwm 43709 (R17 / 609) n
�` y,� / presaibed by DePartmerd oi Local Govemment F�nce �
INSTRUCTIONS:
To be hled in person or by maB with Ne CounryAudifor or Counry Recortier of Me co�nry wl�ere fhe property is located. F� �'°a '
Fii'mg Dafes: 7) Real Properry: Must file dunrg the year Por which tha deduction is wught. � CountyA� r
2) MobRe / Manufactured Homes rat assessed as Real Property Must file during the hveNe (12) rtanfhs G I SO �,rFO�� �^�T R
6efore March 31 of each year the deduclion rs sought 'LY' YY'���
See Jeversa side Ia� adUitional instructions arM qualifications.
AnK t ownrer mntad buvec. see m�n:^M�- m mvnrsa tiirl i /] . �
artent yeer
tt m, what Is Itis I her esad sha�e ot inieJVSi'>
It runie m remd'o EiRerent Man ihat ot app6mnt, Sdifata Gelmr.
Nartre W rtiortgagea or mntraG sellu�/� /�� �
f
Addrea oT rtnrtga9ee w contraci srAer (nwri6er an 4 ciN. stete. eM i
Name ot assignee or other owner or hdder of mortgage
ACtlress of assgnee (num0er aM sheet, rlty, siate, aM Z/P cotle)
Does applicant ovm propeny in any oNer If yes, rfiat muntyt
munry in Indiana? ❑ Y�
❑ No
.� %�o- � �D/.� � '�'
i as of Mortgage I Can� intlebiedness unpaid as d Is Ne epplkant 1he sde
Aate o( appYption ,�"/ �� /�� legal or equiNaWe oM+m17
/ � �(V, WO ❑ Yes ❑ No
rc awnea vrim sommrre anu man sp�wse. inairate wm wrom
Is GroPertYinque5tion:MfwwaOyASSessetl
Real Property ❑ NmUa�y0.ssessed
What Taring
Drduaan aPP�d'ci Gre amount ot �_. _- - —
zo— �— C;ui��vv�✓�, Juoy zo
Has Nis detludirn Eeen
for w�n� rean
�
� P�Y
❑ No
zo_
Sign3Arte N Counry Auditor /� /�.V-�-7/ I Oate (mwtlh, daY. y�s�
r�
I I We ceNfy under Ihe penalT /a — L/� /] f) nd correct arM Nat the appli�ant is a resident of Indiana arM
owner I cantrad buyer of Ne : � �� � j
I Sg (ownal3 reme) Date (rrmtl�. daY. YgeA
n /
� t a t(number antl stree4 riry, te, aM LP cotle)
/�
Pe15on autlnraed by dWy eze�uted Porer of Aimrt�ey w by IC 61.1-12-0.7 ' Date (monN. tlaY. Yae�
Pddress ot auNOr¢ed persa� (numberalM stree; tlry, sbta, end LP oode) .