HomeMy WebLinkAboutMortgage_Howe""�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
• FOR DEDUCTION FROM ASSESSED VALUATION
" SFate Fomi 43709 (R11 / 6-09) .
S 1 Presaibed by OePartment of tnd Govemment Friaxe
i e ark
INSTRUCTIONS: 1
To be fiied in erson o� 6 mad with the Coun Auditor orCoun Recorder of the coun where Ne ro �''"�'
P Y N ty ly P Perty is b . 1
Filim� Dates: 1) Real Property Must file durirg the year for which the deduction is soughL � Counry Auditor
2) Mo6ile /ManuFactured Homes rrot assessed as Real Property: Must fi!e dunng the twelve (f 2J rr&n
6efore March 31 of each year the deduction is soughi - County Recorder
See reverse side !or addifional instructlons and qua/fications. U NTY AU DITO R
AppGCant wcontraCbuyer-see anreverseside)
T" isIIiG � Key number/ legal desoiption R¢corA num0er Pape numbel
z- i - 0 7, ao - 00,3y ou3 -o �- S � o 0 7 Y
Ase�ed value �d mal pfoperty a of Mortgage / ContraU 4dehtedness unpaid as af Mangage I Contrafl uWebtedness unpaid as ot Is Ne appfi�ant the sole
Alamh 7, qc�ent ypar Mamh 1, curtent yeer date of appG�stion or
kgal equitaNe owne(1
DD ❑Yes ❑No
Ii ro, what ts Itis 1 her euct share of inferes[? tt wmed with someane other n spouse, iMircate with wfnrn
If name on remrd is drtfuun ihan Nat o( aDP��l mdibte 6ebH'. Is ihe property in Ques4an: MnuaMl�ssessed
[�Rea� Proaenv ❑ ?n�ua�N wssessea . . _
Name W mortgagee w mntraG seller
nadress or rtwnyagee w cw,eaa sen
Name af assi9nee w otlrel awner or h
Address of assigrree (numbr! arid sm
Dces appl�mperty in any o1
munry in Ind'ana?
❑ Yes
20
��
I I we
ea Yi ihe artmunt a:
20 _
ry NMitor
• T• �-
under ihe penatty of
ac[ bwer of the afor
115 6 C
umher and sLee{ ciry, stafi, and LP wde)
M rtwrtgage
iry, slate, an0 LP code)
� /3 .� ��
IfyeS,wha[munqR WhatTa�d(g
❑ No
COUNTYAUOROR
� vl'81V�C �'0...`; `, �,�,�......
Ca1'd 1�'O: ......
������9a ��....... �o
/
20_ 20_ 20_ 20_ 20_
Counry Date (rnanth, day, yea�
he abov d foregning infortnation is W e and correG arM that the applinnt is a resident ot lndiana arW
>mperty date ' tion is fi
' _ _ (1 ^ Date (mwAh. QaY.l'��) / . _
5ate,
uNO�A by dWy exeai�tl Power otAttomeY w by IC E7.1-72-0.7
of auNw'¢ed person (numberarM sbee4 �: state, aM ZIP code)