HomeMy WebLinkAboutMortgage_Barton'°'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
_ - FOR DEDUCTION FROM ASSESSED VALUATION
' • Sfate Fomi 43709 (R71 / 6O9)
•�' ,«. � pr¢srn"6ed by Department ot Lacal Govemm¢nt France
INSTRUCTIONS: �
To be filed in person or by mail with the CouniyAUditor orCounry Recorder of the county where [Ae property is ocat . 1
Fii'mg Dates: 1) Real Pmperfy. Must fi(e dunng the year /or which the deducfion is sought.
2J Mo6ile / Manulactured Homes not assessed az Real Property: Must file dunng the hveHe (12J mont� V
before March 31 of each year the deduclion is mught.
See reverse side (ur ad�itional instructions and qualifications. C.`�.
(�f//l,l,Nt� I C`.(t0— —C/7—
assess�C value or mal yoperty as or rnor�gage � ca,o-aa t
Mardi 1. nment year Ma`U 1, curtent ye�
tl no, what Is his / her eraC share of interest?
tl na�'re m remtl'a dMu�t Uun ihat o! aPP�m. ��� �low.
Nameo(mortgagee
Addr� of mortga9ee a contracl seAer (m
Name al assignee or other ownu w hdder
Adtlmss of assig�e (nvmberared.
Oaes eDWkant rnm property in an!
munry in IM�ana?
n YE
a���a m u,e a„�,m
r�Y, sbte, ard
[1 CountyAUditnr
T=�j� Z County Recorder
`— lu �' U 1'LGI6SON COUNTY AUDITOR
Record num6er Pape
�l.a�.�?-O� O/� �
unpaitl as a( Mwigage I Contrarl uWebtedness �mpaid as o( Is Ihe eppOcant the sole
/�/�� date o( aPP�� �egal or equltable oN+�
DL�/ ❑ Yes ❑ No
If awneE wi� someorre otRer ihan Spo�se. 4dimta Wth xRm�
Is tice property in Quesuon: MnuaMAsse�ed
� Reel ProPeKY ❑ ?!m!�a�1! Asse?sed . . _
D1":l\1'CI' \�.....�l.�....
Card NO. ...� o �•�'.......
� / �J�,1�0. L7
far
� P��Y
❑ No
20_ zo_ zo_ 2a_ zo_ zo zo_
yrs W Caunry /� /�� Date (monfh. daY• Y'�A
�����
I I We certify u`Wer Ne penatty of perju that the above an foregang infortnation is true and cortect and that Ne applinnt is a resident ot Indiana aM
amer I wntracc buyer of the aforeme�oned property on d te application is filed.
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�S'I.�"�f S l�7mSa� S��L/A�t-G�- �- �f%l��o
Pelson autlw�¢eE Dy dWy ezewted Pawer of AltomeY w by IC Gt.t-12-0.7
AEd� W autlior'ved prJwn (numberantl sbeet, ury, slala, aM LP mde) .
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