HomeMy WebLinkAboutMortgage_Parker (9)J
^'� STATEMENT OF MORTGAGE OR CONTRA ��E MbeS Coun 7ownship Year
• FOR DEDUCTION FROM ASSESSED VALU( T Of� ^
•�� � :• State Fam 43709 (R71 / 6-�) O`(�
S�„ I p�esmbed M OepaNrient af Lual GwemrtreM Firunce pEC 1g1 File Mark
�srnucnoNS:
To be filed in person a by mad with the CountyAWitor or Counry Recorder of the countyCwh re the pro �{� Fart(n, �me,a �with:
Fi76g Dates: 1) Real Pmperty. Must file dunng the year for whkh the deduction is sought ,,n`,NjY ^" `��oCounry Auditor
2) Mo6Ae / Manulactured Homes rrof assessed as Real P/uperly Mus! filg�g.rnaCweNe (12) months � �unty Recorder
6efae March 31 of each year the deduclion is snughG G�s
See reverse side for additronal instructions and qualifications.
Appfrant (awrera corttrart buy s�rnC+c�+ns� reverse s6de)'
T
7 ' D' 'G KeYmanberlleBaldesaip.
-U
value o( real poperly as oi MoRgage / Cantra
1, acrent yrar Marrh 7, curtent y
� yo�
n m. whst fs nis � ner era� dwe or intem_v?
If name on reco�d "s dMemnt Nan Ihat of aPP�. cqirate 6elaw.
Name af mortga9ee or contraC seJleriy{ � ^
C� �� J
contrad seller (num6er end s0ee; cdy, stata.
Name af assi9nee w othel owner ar hdder of mortgage
AdCress of assi9nee (numberard street �1; s+ate, arc
Does ePplimnt wm propeM1y in eny other
counry in Indaia? ❑ Y f ❑ No
De�u ' apprwr.E'v� �he emwnt of.
20 _ 20 _
SigreMe d CAte:ry NuditOr
Record numher Page numbe+
aa d��� �ig
as of Mongage I Contrarl indebtedness unpaid as d Is Ne eppfi�ant Ne sok
Oace of appGCation legal w eqwtaWe ameYt
❑ Yes ❑ No
����������_�.������
ts me waa�v in auesrion: nnnuaM wsses,ed
eal PfoPerty ❑ Hi?iva��Y 0.sse�ed . . .
LP code)
ir,r�. �� m��nn wne�,
COIINN AUDITOR
2Q _ � ZO
(( �Y. 1 .Y:.....
DI':1\\'G• \0..••• . � I
C:11'Ci 1�.I '....?Y.I.!„I........
� I iVVo. �
�+�
❑ No
20 _ I 20 _ I Z� _
I I We certify under ihe penaky of perjury that the above and foregoing intortnatlon is true and cortect arM tha[ �he applinnt is a resident of Ind�ana afd
owner contracl buyer of inentioned pro rty on date appficalion is filed.
re (ownefs hdl imme) � Date (rnor+th. daY Y�e/)
Fu0 rrside�t eddr�s of a t umber and streeG �+Y. ��e, LP cotl )
�l�.z! E s l�, f�u4-tis�� -�� f�G 39
Pason autharzed 7y Otdy eaxwced Power o(Atmrney w Cy IC G7.1-12-0.7 �s (��. �Y• Y��
AAdress o( auNa'¢cd person (numberaM street �+�Y, s+ate. and LP code)