HomeMy WebLinkAboutMortgage_Wolf (2)^�n STATEMENT OF MORTGAGE OR CONTRACT INDEB�N�S n Tovmship Year
a.�—
� FOR DEDUCTION FROM ASSESSED VALUATION �
� State Fom 0.1709 (R7116-09)
S �,. � �,���a�,���,��F� DEC 2
Fle Mark
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To be fifed in person w by ma� with the CourttyAuditor or Counry Recwder o/ the county where fhe property is Form med witn:
Ffiug Dates: 1) Real PropertY. Musf file durirg tAe year for which tha deduclion is soughG Counry Audimr
2)Mo6�le/ManufacturedHomesrrotassessedasRealPruperty:MustfiledSw�BANvA�41�TX�BnN�1T0 �unryRecorder
6elore Ma2h 31 of each year the deduUion is sought �
See reverse side for additional inshuctions and qualiiicafions.
Appfp�ani (ownar or`pqtraG 6vye� ;see re,fhiqtions m reverse sede)
����P�D�Ya%�
1, aaratl ye2r
If no. what Is his / Mr e�raU share ot inten
tl nama m remfd is QEferent Ilun ihat ol
Name a mortgagee « mno-aa sener
Address of nartgagee or mntraG se0er (
Name or auignea or omer ownu or nwa
ALCIass of a5signee (numDer arM streeS
Dces ePpli�ant wm property in any oNer
munq m Indana? ❑ Yes
�
prduGion approved In the amount of.
i aesmPmn
-, �- Z� � �. � oa
y�e / Cantra¢ 4dehted�ress unpaid az of Mortgage I Contraa debtednes
1, wrrent year date of aPpG�tion
H wmetl wiM someone oiher Nan spouse.
eGP���. trM'rca� 6ekw.
��3
number and svee4 �l: �+e. ard:
er of mwigage
ary, state, arM LP code)
If yes, what munlyl
❑ No
20 _ 20 _
�Wre af Co�mNlwditor
R¢wN n�mbrl Page numOPi
�0 6�
unpaitl as of ls the aOPfi�ant the sde
lepal w equitade amefl
❑ Yes ❑ No
Mitate wiN whom
perry in OuesCon: MnuallyPSSessed
PfopertY Q Afmua�lyA5sa55ed . . .
�0�� %RAG� �2 -
M'� '��. /�
/ � �P / / / ' P � No
20 _ 20 _ I 20 _ I 20 _ 20 _
Tcamry oate pno�w, ear. ree�
1/ We certify under ihe penatty of perjury that the above aM foregoing infortnation is true and corteG arid that Ne applipnt is a resident of Indpna aM
ovmer I contract buyer of the aforemerrtioned property on date appliration is filed.
adEress of a�0�ant f�number arM strlE4 dry, stata,
pelson (numbereiN sCeet, rity, sfafe, aid LP code)
�/ 76
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