HomeMy WebLinkAboutMortgage_Vanzo (2)"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_, � FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709 (R77 / 6 W)
�` pr¢svibed by Departmenl ot Lnml Govemrtrent Fuance
�wsmu� � � Fil
cnoNS:
To 6e filed in person Or by mail wifh Ihe CounryAuditor or Counry Recortler o7 the county where the property is �
Frfiig Dates: 1) Real Property: M�st file during the year for which the detlucfion is sought. � County Auditor
2) Mobde / Manuladured Homes not assessed as Real Property Mus! file during the twelve (12) months � E p�� �,y�nty Recorder
6eto�e March 31 0! each year Ne deduction is sought. o Ut
See reverse side for addifional instructions arid qualfications. ^ m
�,�„o,.�,�,��ab��.�f,��,�,�,��� 7 / _ l\ �
�ri�:o'Ej°�
m, wn�c s n� � n�r �ua snar� a�w�r
— l!o — /00 — O�
�/ ContraU intlebtetlness unpaid az ot
wrtem yrvr
name m�ewrE it EiRerent Nun that of aPpGCant, uWirace Gelavr.
IJame ot mortgagee or
If awned wich
Mdress ot nwrcga9ee w cmbaci se0er (nvn6er and sbeel, ray, slate. aM LP cade)
Name of assignee w other ovmer or hdder ot mortgage
AEdrnss ot a� ee (number aM slreeL dry, slate, and ZIP co0e)
( itu.�v�-'�n..i �� .d� � �-
Does eP�nt own property in aNbU
munryinlrWwa? V
❑ Yes
Deducfim appoved N the arrount of.
zo �_
sgretu�e W Coimb AW itor
.T Yk-�
I I We certy under ihe penalry
owner I mntracl buyer of the a
�sigraw/r��(oxnelsfironamey%�7
i/7 �//1.s� !� /lG
/ So _ o a. � ao i a ��gJ�
lga9e / ContraU iiWebiedness unpaid as d Is ihe appG�ant Ne sole
i of aPP�� � w eWita6le ownM
� g ❑ Yes ❑ No
sortieane aher W n spouse. hMkate wtth whom
I5 pie prope`ty in QuesCOn: MnuaOyASSessed
❑ Real ProPenY ❑ �^^!!�Y� . . .
�
Has �his deduction Eeen re9uesteA m P�Y
ror a,rtem year. n.,_ _ n
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5.a. s�...... � zo_
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that bove and foregoing infortnalion is W e and cortect and Nat the appliran[ is a resident of Indiana arM
ned r perty on date appliration is filed.
Date (rtronM, day, yea�
ss W applirant �ffumber arM street dry, sbte, aM
�cS/QR�ss7 %J2/✓i /
�y duly executed Power of Attomey or Ey IC 61.1
person (numberarM snee; city, stare, and LP cMe)
..� L/7L3
Date (mmN, day, yea�