HomeMy WebLinkAboutMortgage_Spencer (2)"'�+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
5-_ . FOR DEDUCTION FROM ASSESSED VALUATION
• Sfata Fam C3709 (R71 / G09)
�' r PresaibeC by Deparbrierd ol Local Goverturmnt Fnance
�«.
File Mark
�STRUCTIONS:
To be filed in person a 6y mail with the CounryAuditor or County Recortler of the county where the property is focated. F�' ��h�,,,�nnn �'
Filirg Dates: 7J Real Property Musf file dunng the year /or which the deducfion is sought. � Counry Auditnr
2J Mo6�le /Manufactured Homes irot assessed as Real Property: Musl file dunng fhe fwelve (72) months
before March 37 of each year fhe deduction rs sought. Counry Recorder
See reverse side 7ar edditbnal instructions arM qualificafions.
AppGCae t(ownerQr oontracf b�yer- �ee resfiirbont m reverse sife)
:ed rdire d rrdl p'apaty as d
r re
1, qll¢N year
It m. what is h's I her e�1 sham oi interest?
Nan
Name o( rnutgagee or mnvxt se4u
kutgage / Gontract IrMeOteCness unpaitl as o( Mortgage / G
7arch 7, wrtent year date of appOc
� aa
If owned with mmeone
uidicate below.
Address of nwrt�agee w conbaG seAer ( number end sbeet u�l: sfate.
Name of assignee w aUwJ owner w hdder of rtprtgage
assi9nee (number eM s�'eet �+N, sbte, aM LP ootle)
oocs eQplkant wm property In eny ot
munty m intliana?
❑ Yes
Detluctian apprwed in Ihe amount ot
rl��
Sigr�ahrta a( CounN Auditor
20 _ � 20
YMat Ta�drg DisUict?
COUNTYAUDROR
za zo
I/ We certify undel ihe penalty of perjury Ihat the above afW foregoing intortnatlon is tri
owner / contracl buyer ot ihe afaementloned Droperty on da[e appliralion is filed.
rry, sbte, ard LP wtle)
.✓ /f�tv.s srr�r /,✓
rn Cy IC 61.7-12-0.7
Atldress of au[f�ed person (numbef aritl sbee; tiy, state,
a d Is Ihe spp6rant tha Sde
legal w equilade owneYi
� Yes ❑ No
Is Me property in a���: �nually Assessed
�eal ProPenY ❑ A^^uali�' Assessed
Has �his deductim Deen reQuested on property
far artent yeall
❑ Yes ❑ No
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