HomeMy WebLinkAboutMortgage_Dunkel^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun hip ea �
_ • FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fwm 43709 (R71 / 6-W)
�' � p�esaibed by OepartmeN of lttal Gwertvrrent Frw¢e
i a
INSTRUCTIONS:
To 6e filed in person w by maii with the CounyAuditor or Counry Recorder of the county where the property is located. F �
Fi7ing Dates: 1) Real Property. Must fJe durirg Ne year for which the deduction is soughf. D Coun i r
2) Mobde /Manufactured Hanes rrot assessed as Real Property: Must file during the tweNe (}2J rtanths G I SON�IOI�f���R
6e(ore March 31 of each year the deduclion is sought. LJ
See reverse side !or addrtional instrucdons and qualificaLOns.
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tt name an recv�d's SAfwent Nan ihat ot aOP��L hbinte 6elox-
Name oi rtaRga9ee ar
ar rnntraU
al assignee w othrl owner or haldu ot rtprtgaga
� D�PenY
atree; uTy, state. and ZlP code)
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i as ot Moripage / Contrac2 indebtednes
data of appf
ffOWfIBdW1111501I1COf1E0i�18f SpO115E.
-ia
iitade awnen
Yes ❑ No
Is C�e Property in question: MnuaM Assessed
�ieal PmPeKY ❑ AmluallyASSe.SSed
—3-
�. �a/�
Has Nis deductirn Deen requested m P�Y
for wrtent yeaR n Yrs ❑ No
- COUNTYAUDROR
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/�D 20_ 20_ 20_ 20
Cel'd ��. ..........�........
�n .. Caunry �ate i�h daY. Yee�
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I,..e ��u�y u�aer u�e penairy or pe�ury Nat the above aM foregoing infortnation is We and mrrec[ arM that Ne applirant is a resident of Indiana and
owner I wntract buyer of the aforementioned property on date appiication is 51ed.
(owne/s fui rem� . . _ �. O Daie (month. daY. ya� _' _
aEtlrn«
tify, state, arM LP ootle) _
aerson eW,«¢ee ey aWr exea�:ea aower er ntmmey o.7r �c 61.1-u-0.7
Address af a Wiorized per:m (num6erand sbee{ ciry, state, en0 LPCOtle)