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HomeMy WebLinkAboutMortgage_Whittington"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Townshi Year � .r— • FOR DEDUCTION FROM ASSESSED VALUATION .• State Form 43709 (R71 / 6-09) •�' � Hesrnbed M OeG�reM of Local Go+emment Frw�ce File Mark INSTRUCTIONS: To be fifed in person w by mad with the CountyAuditor or Counry Recader o/ the county where the property is bcated. F�"� � ' F�Ting Dates: i) Real Property: Must fJe durirg tha year fir which fha deduction is soughL �C y� 2J Mo6de /Manufadured Homes rrot assesced as Real P/nperty Must file dunng fhe twelve (12) months before March 37 of each year tAe deducfion is sought. � ❑ County R See ,everse side /or addifional instnrctrons and qualificatians. MP�^� (o wmntrad 6N'�'see resNCW2s m rev�trsY sibe) •. � . 1 n�m��r��,.��r Ma�d� 1. armrt year It m, what Is his ! her e� sham ot interest? >MortXpa9�.SU l — March 1 e/ ConuaU 4det ay�ap�mar _ It name m �emrtl's Srttemn[ U�an Vut of appGrant, trNkate bebw. Hame m mong23ee «ca,raa sener Address ot mor[gagee w mntract seller (numbel a� Name a1 assignee w oMer owner or holder of mort� AAdress o/ assignee (number and street �; slale. Dces epplipnt oxn property in any oNer munry in IM�ana? ❑ Yes ❑ f: DrducGOn aOWaved'o� tl�e amount of: zo _ �o _ 1 Sigrenne N Cowry nuditor ciry, .�av /. � aid as af Mongage I Contrac tl2te O( app�tion 1/ owned wi� sarneo�re oih� a af Yes LI No Is tl�e ProP�Y in Questian: MnueM Assesse0 ❑ Rea� Froaertv ❑ Annua�ry Pssessed - - �_. _ � • 'IPCOEe) . I � . �- •�_.. �' ' "-• . �� .��.' � iias this deduGian been . . rm cvirem yeaR • �' . ' . '. F�� I� � • Di•a����°i� NO..4!�.O!.:1..•.'..... �; c���a .�o. .. 5��.`1......... �y9;a97: C° 20- Caunry �Y. Yea�) � P�Y 20_ I I We certfy unAer the penatty of pe�ury thai Ne above and foregoing infomiation is W e and cortea arM that the applirant is a resident of Indiana aM owner / contract buyer of the aforementloned prope un date application is filed. � ra (or^ na -. „_ _-. Date (monfi. EaY. Yge+) erM person (num6era�MsOee; Date (rtanlh. tlaY.