HomeMy WebLinkAboutMortgage_Perry (10)"'3 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
.._—
a FOR DEDUCTION FROM ASSESSED VALUATION
� Slate Fom 43709 (R71 / 609)
�' � Presrnbed M DeP�rd of Local GovttnmeM Firwce
File Mark
INS7RUCTIONS:
To be filed in person or by mad with the Co AWitor o� Coun Rewrder o/ the coun where the ro ���
�r N b v aenrawcared.
Fditg Dates: i) Real Properfy Must fJe during the year for which the deduction is soughL ��p�
2) Mo6Ae / Manufactured Homes rrot assessed az Real Property. Must file dunng lhe hvefve (12J monNs
be(ore March 37 of each year the deduUion is soughG ❑- County Recorder
See reverse side tor addrtional instrucGons arM qualfications. —
MWcarilfox+rer w mntrarl huve� - see �C+�i�s m reverse sitel . .
Distrid
rc m, wna�
Ii twre on
Name af rtqRgagee w mntracl
aea� a ��� «m„r
Key rnanher / legal desaiPtion
�� ' ��� �
Mortpage/Contrac[4
Ma�1 cvrtenlyear
ihat of app6�nt, trdhate 6elax-
�.
Name at assi9nee w oUrer owner or hdder of mwtgage
ACCress ot assignee (number arN sLeeL d}: slate, ZIP potle)
��,, 0085 -oo T� D l�
Does epplinnt ovm pmperty in any oNer I( yes. wha[ munt�/1
munry in Indiaria? ❑ Yes
❑ No
Z�_ 2�_
xaaNreorCoim aitor �
I/ We certify nder Ne alt
owne,id contract buyer q�he
zo � zo
Ls Ihe appGrant Ne sde
legal or equllahle owfwll
❑ Yes ❑ No
Is tl�e P�P�Y m questim: MnuaM AscsseE
[�eal PmpeKY Q AIV�Ua�yASSes�ed
/.SP� // .
What Tad� D'sGicCJ Has Iho dedudion Oeen rt
tor au�enc year) I
_��
4UDROR ��� a F P��
Z ��--����
that ihe above and foregoing informalion is we
ned property on date appiiration is filed.
Prlson authoracd by tl�y execvicetl Power o(AttwneY w by IC 61.1-12-0.7
Address of autha'¢ed prlsm (numbe� arnl sLeef, firy, sbfe, and ZIP oode)
Dale (rtwm�. w,.,'_.,
����v
nace c�a�,m, der, r�et
� P�Y
❑ No
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