HomeMy WebLinkAboutMortgage_Hinton (2)"'� STATEMENT OF MORTGAGE OR CONTRACT INDE�D�I�S C n Township Year
_ • FOR DEDUCTION FROM ASSESSED VALUATION 1 YJ
Sta(¢ Form 93709 (R71/609)
�` y,� I p�esrn'p¢d by Departmenl a1 Lofal Govemment Frunce DEC �
File Mark
INSTRUCTIONS' �, � F�q��.
To be h7ed in person or by maR with the CountyAWitor or Counry Recorder o7 the county where trie property
FRrg Dates: 7) Real Prope/ty: Must file during the yea� for which the deduction is soughL Counry Auditor
2J Mo6Ae / Manufadured Homes rmt assessed as Real Property: Musf file dyr���t�q}�g �:qQ)'�Q�TOR
6elore March 31 01 each year the deduction is s�uyhG - �� County Recorder
See reverse side !or addrtional instrucGons and qualifications.
AoMraac(ownerorcont2r16we!-seere5bicbonsmrevMSesiCe) /•
T�p Key �wmher / legal �'smption Recotd num6er Page numbu
/.(/ - - �a �/ CL� 07 �.3/ �J/ �
Ass� vaM1m d real aa af Mortgage/ Contracl intlehtetlrress unpaid az ot Mortgage / Con� uWe6tedness unPaid as d 4s the eppfionl Ne sole
Me� 7. tamerrt year March 1. wrtrnt yeer date o( aPP��� legal ot equitade v.mdl
' ❑ Yes ❑ No
tt m, what is his / her e�d share of interest? H wmed wiM someone othar tlian spouse. I�icate wnh whom
If nMie on reCNd
rtortgagce w rmtracl seAer lnwMrleM strae4 �Al: ��. aM Z/P mde)
name ot azsu,picre w omu owner or nmer m rtonc
PDaess af esti9�� (numbrr ared sLeeL �1: swe.
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2Q
any
appfoved'oi Me artrount of:
20 _
co0e)
Is the ProPeM in Quesccn: MnuaM Aasessed
�teai a`°perry ❑ A`°u'a�yA�e�
Modle Hane (IC 6
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'� COUNTYAUDROR 7 , /
2Q _ 20 20 _
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20 _ � 20
Date (mrkh. daY•
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I/ We certlty under the penatty of peryury that the above and foregang intortnation is true and correu and that ehe applirant is a resident of IrM'w�a arW
owner I contra�srt buyer of the aforementioned pmperty on date application is filed.
lrenue (a fiAI na /l Data (rtwWi. daY. YBeA
(number antl shee4 aN, �C. � LP code)
Power of Attamey w by IC
Address W aWm'veO OPn� NumDere� witl sbeeC �: sfale.
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