HomeMy WebLinkAboutMortgage_Newton^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
_ : FOR DEDUCTION FROM ASSESSED VALUATION
Sla[a Fartn <3709 (R71 / 6-09)
S,� i p��i'p�,y 6y DepartmeM o( Lxal Goremment Finarce
INSTRUCT70NS: ��
To be fi7ed in person a by mai7 wiN the CounyA Witof or Counry Recorder o/ fhe county whem fhe property' t
Filirg Dates: 7) Real Property Must file during the year for which the deduclion is sought. � Counry Audiinr
2J Mobile / Manufactured Homes rrof assessed as Real Propelly: Must file during fhe fweNe (12j monthr r I Trtl �f Counry Remrder
before Maich 31 of each year the deduUion is snughG V«• Y 6111 L
See reverse side (or additional inshuctions and qualifications. C�
nvwran+�o»T � conaacnuye.-=�sRSV:LORS�,rev�a!e�de) �l . T l �
� I[J�1•/�
A1afU 1. ament 7rear
If ra. vfiat Is his / hw eract shara of interesi?
If name on remrd is dRferrnt Nan �hat ot appGcan; hdirate helaw
Name of mort5as� a contract
mntraclse0er
af assi9nee u o1Aer ow�er or hddu M
of assignee (nvmber arM street, dry, state, antl LP cade)
Does ePWi�2nl rnm P�PenY
counry in Ind"ana? r
ctian approved'c� tlre artrounl of.
20 _ 20 _
a �
date
legal
tt awned wiM someona oMu Nan spouse, IM'�te with wlwm
'� `�`�,� 0��� -
�,01'�- ..... _
D�•���`CT \� .............. . _
�O �I�l��...........
Yes ❑ No
Is ihe pfoperty in Ques�on: MnueM ���
❑ Real Pmperty ❑�nmua�yassessed
�MOd7e Fbme QC 61.1�
Has Niv tleducfim been 2quested on p�operty
(ar cwrent Y��! � Yes ❑ Nu
2� _ 2� _
Date (rtnntl�. daY. Yea�)
I I We certify undet the penatty of perjury I C.11� (� 1 ' __...,�.a atW �hat the applipnt is a resideni of Indiana arc1
owner I contrad buyer of Ne afo2menfiw ..,,� � rs nled. '�
�e (owneY: fiill me) I Date (monfh, day, yea�
FuP revdant d\�//�/��ndshee4 a'fy s�te, enC LPmtle).
Person authomeC Dy duy execyeed Power o(AmomeY w by IC 61.1-12-0.7 � Date (monfi. tlaY•YBe�
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