HomeMy WebLinkAboutMortgage_Bryant"`n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
r__ + FOR DEDUCTION FROM ASSESSED VA��� ��
• State Fwm 43709 (R71 / 609)
� PresrtiOeE by DepartmeM of Loral Govemment Flrenta
w File Mark
�vsrRUCnoNS: nC(� t1 f� ,f�1
fo be �led in person or by mail wiN the County Auditw or Counry Recorder o( fhe�y�fvnlr4Mk�perty is locafed.
Filirg Dates: 7) Real Property: Must file durirg the year /or which the deduclion is wught.
2J MobBe / Manulactuied Homes rrot assessed as Real Property A�ust�7att�ehre (12J months
6e(ore March 31 0l eacA year the deduction is sought. 1, r\
See 2verse side 7or additional instructia�s arW qualificafbns. v
NT AUDITOR
MPUtam (o�mer or , buyer- sea ijstrictioqs m reverse�) ../l/7 . r . i.
AsSessetl raYie U mal papsty as
Mach 1, anent year
II no. what Is his / her era`Y slare of interest?
�"�`�`la�o
It name m 2coN b 6Rerent Nan ihat of aPP��4 ��� beb�c
Name ot rtartgagce or mnaact se�er
a mntraa
ownerorhdderofnqrtgage
PLEmss of assgnee (number and suee4 �y. sfate, and ZIP oode)
Does applinnl own prope�ty in anY �er If yes. wta[ munry?
counryinlMiana? � .. � _.
20 I 20
I I We certify urWer Ne penalry of
owner I mntrad buyer of Ne afw
�
�
�
20
F.]ii.'a.'?�:8
What Taidrg DiSViGt?
Caunry
20 _
Fwm filed wiN:
Counry Auditor
Caunty Remrder
Rem�d num/ / I P�e '� O—(
as
epuita6le o�vneR
] Yes ❑ No
than spouse. "uMicate Mitli wMm
Is Me pfopttry in QuesUon: Mnua�y As,usud
❑ Reat afoaenr ❑ A^^�N �
20
Date (monN. tlaY. Yea�
'J^�''�"-.�-. .�l
ZO
foregoing infortnaUOn is We and corted arW that ihe applinnt is a resident of IrWiana and
te applica4on is filed.
Date (^month, daY. N��)
�N—
riry. sfate. arM ZIP mtle)
Per..on authar¢ed Gy dWy exeturetl Power o(AttnneY a bY IC 61.1-12-0.7
person (num�er arM strae( ary, sfata,
1