HomeMy WebLinkAboutMortgage_Lehmkuhler^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year
_, • FOR DEDUCTION FROM ASSESSED VALUATION
:• Sfate Fwm 43709 (R71 / 609)
� Presaibetl N' DepartmeM of Local Govemment Firiance
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STRUCTIONS: nI� 1 ,,,A
To 6e fded in person w by mail wiM the CounryAuditor or County Recorder o/ fhe county where the property is bcat�A. T 1 I C� �
FiNrg Dates: 1) Real Property: Must file durirg the year for which the deducLOn is sought. County Auditw
2) Mo6�7e / Manulectured Homes not assessed as Real Properry: Must file dunng Ihe twelve (12) mo�liS'�. rt �County Remrder
6efore March 31 of each year the deducfion is so t v�_
Seereversesideforadd�ioralinsVUCGonsarMqualfi ti � � CIRSONCOUNTYAUDITOR
�AnKrantlowxror � r-SeereSri�iora�rLersesdel � 1/] 1 A
� //II�U- /�
Attessed vdue d real O�O�Y ��
Marh 1. aamnt Year
II no, what b his / her exa�Y share of inte`est?
U �a1tIC Cfl I2M(t1
i(ress unP� az N MortBa9e / Convact iMeMetlness unpaid as d
� date of applifation
rtnrtgagce or mntaa seqer � � �
of mortgagee or contran seller (number end sveeL �}: state, aM LP oode)
Name of assi9nee w
neaass or assignee
pwn propefty in any oNer
�� ❑ Yes
De�ucCOn app�o.�ed'u� tlre artouni ot
2� _
Sig(aMe d Cotmb AuEiior
518t2, 8M LPODtle)
If yes, what CoUnp!+
I No
�_ , �
If amed wiN someorie aher ttan spouse.
Page
Yes LI No
IS CIC PfOPEIIY RI QUGSt1IX1: Mf1�12�y ASSCSSCd
❑ Real Property ❑ Hrmually Assessed
0.lobile Home (IC 61.
Whal Taring D'abit7 _ __I.u-- �-.- — d cn p�pperty
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5 �n
ap � a ...
pi�a��er�0.....••...• ..
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����� . �a, gs�:� 20—
. . - oace (monm. daY• YeaA
I/ We certy unAer Ne penalry of pe�ury that the above and foregning infortnation is W e and corteG arid that Ne applirant is a resident of Indiana aM
owner I contract buyer of the aforemerttioned property on date applicalion is filed.
uiawre (ovmefs hil nemel /1 Date (nmth, daY. yaa�
PHSOn
state,
by IC 61.1-12-0.7
per�„on (numberaiM s�eet, city, state, arM ZIP coee)
Date (monN.OaY.