HomeMy WebLinkAboutMortgage_Sartore (5)"�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship vear
__,. a FOR DEDUCTION FROM ASSESSED VALUATION
� . � SUte Fwm 43709 (Rit / 6-09)
�' y„ � Presaibetl by Department of Loml Govemment Fnarce
File MaAc
INSTRUCTIONS:
To be h7ed in person w by mail wdh the CounryAuditw or Cowry Recofder of the oounty where [Ae property loca �
Fi7irg Dates: 7J Real Pmperty: Must Ble during fhe year for wbich the deduction is soughL � unty Auditur
2) Mobde / Manufactured Homes rrot assessed as Real Ploperty: Must file dunrg the tweNe (12J rrwnNs
betore March 31 ot each year the deducfion is soughG O C T p 2 c°°�� R�,a�.
See reversa side /or eddiWnal instrudions arM qualifications.
Aoamnl (owner wmn7aC buYer- see tP.SLId'ibns m revarse sidel . �. J. �••_ r..��,
o�s�a
�Y �
�er/IegalEeStription t
'DS- �a-.3oo:.pao. �
ge / Contract inde6tedness unpaid as o( Mor
Ma 1, artent year date
If narne on �ecp[f is CiRerent Nan fhal of aPp6�nt, 5Mireta Eebw
Name of mongagee ar mnvaa �Iler . � n
Address of mort9agce
w ovrer owner or hdaer ot rtqrtgage
cM state.
MCress ot assiynce (number anC e� tlry, state, an0 LP mde)
Sw a�-L- lo �
Oces applkant wm yopMy in any other I! yes, what munry?
counry in Indiana? ❑ Y�
❑ No
zo zo _
i�we w co�u,a aa��
C -
I I We certify under Ne pen ty of
orvngr I contract buyer of ihe afoy
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NTat Tadrg D'u�trirl?
COUNTYAUDROR
zo i zc
the above and foregoing intortnation is we anc
property on date applicatlon is filed.
stafe,
w Cy IC 61.1-12-07
person (numberarW shee4 �l: slate. and ZIP mde)
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l$fN+f9""A�JITO �enu�be�
zr
: unGaid a d Is ihe ePP�m�t ttre sak
legal w eQUibde ovmef.�
❑ Yes ❑ No
6dkate with whan
IS M2 PfOpCflY Ifl G�125LIX1: Mt1U8IF� ASSCSSEA
❑ Real Property ❑ Armualiyl�ssessed
r�oaia rio� nc ��.
Has Us eea�md, eren rev��ea on o�r
forarrentyea(.+ � Yes ❑ No
SE}%�. j� � SU l. �.
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Date (rnonth. daY. Yee�
(monN. AaY. Y��
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