HomeMy WebLinkAboutMortgage_Karaff^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
.,�� _: FOR DEDUCTION FROM ASSESSED VALUATION
' S1ate Fortn 43709 (R71/609)
S � pr¢�rn3¢d by �epartment af Local Govemment Frence
F
INSTRUCTIONS:
To be filed in erson a b mad with the Cou Auditor or Coun Recorder of the ooun whele the ro F� ��1 ��
P Y �' �Y tY P PQrtYislocatecl�OV c Ig
Fifitg Dates: 1) Real Property. Must hle durirrg the year hr which the deductlon is soughL �� ���COUnry Audimr
2J Mo6i7e / ManuFactured Homes not assessed es Real Property: Must fife dunng the hvelve (12) rtronths �
6efore March 31 of each year the deduclion is soughG C. �. Counry Recorder
See reverse side for addrtional instructions and qualifiptions.
npPrnant acorwarlbuyer-seere;tricboruonreversasedey, , � TYAUDITOR
T' Distria Key ivanber / legal desaipq6n U U Reco(d num6er Page numbu
-/9-/ - ao3 -00% a� 6-ha.G e2o/a- S�3
A�ed � qopsry as of Mortgage/ ContraU Indebte0rress unpaid as af Morigage / Con•vact utle6teCr�s unP� as of Is Ne ePPGnnt tha sok
Marh 1. aama Year Mard� 1. artent year tlate o( aDP�'atim iegal a equitahle oxneR
J 3 D O O ❑ Yes ❑ No
rc m, �� �� � n� �e � m��sn rc�rea �m someo� wn� a� s�. ma� wm, �
It name m remrd Ls Gi.7uent ihan Nat af app&aN, cmduate helmr. ,i�s N,/e�����ry- m qurstion: M(waAyASSessed
� '��� �Mntv'IUay�1_1-7
mortgagee w mntraG se9u
S
of rtwrtgagce w mnVaG se0er (nwr�her and
Name o1 assignee or aC�eJ owner w Iwltler
Aadress of asm9nee (number aM stree4 ci
Dces ePD���nt wm property in any oNer
counry in InE�iar�a? ❑ Yes �
Deducban approved'o� the artwnt ot
20 _ 20 _
rtqrtgage
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se4 �Y. s+ate. ard ZIP codej
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Dra�t�er 1�'p,
,�t T�� o 'aL2 I.� . . .. . ..
N� I I Card NO. 5�3�J �
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couNn nuorcoa Q "' • • •
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20 _ I 20 _ I 20 _ I 20 I 20 _
I/ We certiy ulWer Ne penalty of p�ry6ry that the abovy/a
owner I contraci buyer of the aforementioned propertj/on
Sq�anue f`%�
W resitlent addrnss o�appGmnt (number and sbee4 a1Y, state, arM
�Ba3 s.�o �� Fa�+�,4��
Pssan aultwRed by dWy ezea:etl Power of AttmieY or by IC 67.1
yEa�
rW (oregoing Intortnation is true and correU arW ihat the applitant is a resident of Indiana ard
date appfiratlon is fiied.
person (numberandstreeL�ly.sbte,andLPCOde)
Date,rtmnlh. d�y