HomeMy WebLinkAboutMortgage_Bryant"'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
,_ - FOR DEDUCTION FROM ASSESSED VALUATION
� State Fwm C3709 (R71 / 6-W )
�„�. Presrnbed by Departmenl a1 Lad Gwemment Wiance
INSTRUCT70NS: p
To 6e (led in person or by mail with the CountyAUditor or Counry RecoNer o/ Ne counry wheie the pioperty is located. S� 1��09
Fi6rg Dafes: i) Real Pmperty: Musf file dunrg fhe year /or which tha deduction is soughL L� Counry Auditnr
2) Mo6ile / Manu/actured Homes irot assessed as Real Property Must h7e dunng Ne twelve (12) months
6efore March 31 of each year the deducUon is sought ❑.�q1mry Recorder
.., /3/Y�
See 2verse sida for additionel insVUCfbns arM qualilrtafions.
AppGCani (ouTer oricaq72a buyer - see resficOqns t� 2�erse siie) (� �
Assrssetl vahm d� qopa:y � ol
MaRh 1, anv�t year
rc no. w+�a� "s n"a � trer erxc share or in:erestt
- IL�- �5(e � yD3' �
> / Canbaa'udebte0ness unpaid a of
artent yrar
� �i �i . L� C�
If name m femtd's diRemnt than that o( aOP��t hidicate EebM-
or mntrad seder (mmber and strec; ray, state. and LP oode)
m holder M mortgage
Pdtlress of assignce (number aM aheet �Y. s�te, aM LP cade)
Does epplinnt wm pmperty in any oNer
rn,uyi��m�m,a? r-� .,--
ez���:��
e��7��q Recofd number Page num(b}u
'Wl � L �
ge / ConTaa cWe6tedness un7aiE az of h Ihe aPP�� Ihe sole
avPfrca�ip+ kgal eWiraNewmM
es ❑ No
neone attwi than sPW�. 4dicate riN �wi�an
�v�cem m a�cm: nni.+anr wssessea
eal RoPeKY ❑ �°�Y�
Abble Hort�e pC 61.L7
�........
— Dra���cr \O..a�..
If yns, wha[ munp? What Tadrg D'aUict? - � � . . . . . . . .
C:1CC� \�.�.........�
��tiy,8�• .'
COUNTY AUDITOR
20 _ � 20
Counry
20 � 2(1 _ � 20
I I We certify urWer Ne penally of perjury that the above aM (oregoing infortnaliM is We and Cortect afM that Ne appGrant is a fe5ident of Indiana aM
owner I contrad buyer of ihe aforemefrtioned property on da[e application is filed.
I (owne hAreme) Date (nrmR�, da Yea�
�'�i,�. /� ,') Q,. . -r 9 . �71-t>9
retitlem
ezecutee Power otACCOmey or oy
Pdtlress of aWiwtred persan (numbe�arnl st�ee; riry, sbfe.
aynC 21P oode)
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Datc (monM, OaY. Y��