HomeMy WebLinkAboutMortgage_Market�1 `'
i
"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ .- FOR DEDUCTION FROM ASSESSED VALUATION
� . • State Fwm 43709 (R71 / 609)
�' % Preun�bed M DepartmeN of LoW Goremrnent Frwce
�� � ile
1STRUCTIONS:
To be hied in person w by mail with !he CounryAuditor or Counry Recorder of the county whe2 the property is bca .
Fdirg Dates: 1) Real Property: Must file durirg the year for which the deduction is sought. Cno'�uJnty Auditur �
2) Mob�7e / Manufactumd Homes not assessed as Real Property Must fife dunng the hvelve (12J monNs O T 1/ Z¢C(�nry Rewrder
before Ma�ch 31 of eech year Ne deduction is snught.
See reverse side /or adUitional instructions erM qualifiptions.
Ava6Fqm (owre� orconaaa buyer- see resvictiws on iererse sjiie)
Key.ruan6u / legal desaiption
1/,. , 1 1 _/ Q_
'3?'q1
m iemrd's ddfemnt than �hat of aPP�t "uWkace belaw:
r��re ot mon¢a�� «r�
Address of nqrtga9ce ar
Name a assignee «oue
, �:n
C.
04-o��,DO�-o�8 �.o/a-- S=�Y/A
ress unpaid as d Martgage / CantrarY @debtedn�s unpaid as d Is Ne epp6mnl Vre sde
Eate of appOption k9al a eQui[aNe oxnM
Y �,, �/DO ❑ Yes ❑ No
�t awrred wrth wmeo�re otne. man sca+se, uWicate wim wnom
�(/V'- -%. C � C� .
aG seAer (numberend sbee4 �1: ��. aM 21P code)
nerwtwlderotmatga9e
aid snee4 �; slete, an ootle) y Y P r
0!/A� i
Dces epdiidnt wm Woperty in any �er
counry in Ind'ana? � Yes ❑ No
�� � m � a�,�� oF
20 _ 20
SigreNre /ot� Co�mN Audimr
l - � '
I I We certfy under the penalry ot rjury Nat
own r I mntract buyer of Ne afo2mentioned
� Si9naw (owne/sfuUreme
[
WI resident adtlress of appficant ( mDereM sLee4 �
� �l � 0 �.,. PL
Penm au1M(rzetl Oy tluty executed Power NAttuney
PdEress of autlior¢ed person (number arnd stree; dry
If yes. whal
!1�I�71[�7:7
Is IM P�PertY in questim: Mnua�y Assessed
�Real RoPenY ❑ Armually ASSe55ed
a�o� r� nc ��.i
�ud'an Deen reGUrsted m property
vear?. _ r_� _.._ n
D�-:�„����.io...�?.(a......
20 _ 20 _ `I/ ,, _
Car(d� NO. ... �.1.`-�'..... —
CamN Fb �a � � �
TI
h ve and foregoing infortnation is We and cortec[ arnl that Ne applinnt is a resident of Ifxliana and
rty on date appficalion is filed. •.
Date (monm, OaY, lee�
slate,
�/K� .�h�.s�
�ad
__""____"'""""'""________"""____'___'""____________"""__"'"'_"'__________""""_""_""_'"""__""_"____________"_"_"'"_________".[_ ___�