HomeMy WebLinkAboutMortgage_Thomas^'�4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Year
+ FOR DEDUCTION FROM ASSESSED VALUATION
n S1ate Fotm 43709 (R11 /6-09)
� � Presaibed bY DeG�+�nt af Local Govemment Finaice ..._
File Mark
INSTRUCT70NS:
To be filed in persan w by mad with the CountyAuditor or Counry Recorde� of the county where the pioperfy is �� �� ° ���
Fdiny Dates: 1) Real P�operty: Must file durrrg fhe year Por which the deduclion is saughG Counry Auditor
2J Mo6de /ManWaclumd Hanes rrot assessed es Real Praperly Must file dunng fhe fvreNe (12) moNds��
before March 31 0( each year the deduction is soughG Caunry Recorder
See reverse side foradditional instructions arM qualihcations. N COUN
Mo��leW�erwcanhaGbuyer'seereffiicOODAOn2wr34�e) 1
a/ legal dewiGtion Recofd num0er
- - 3/ - �o _ DoD. 3./� _ pp �.
MoRgage / Contract GWehtedness unpaid es of Mortgage / Convact inde6tedness unpaid as of
Mamh 1, curtent Y� tlate o( aPP� .
�'f. % a
his ! her eYaa share o� interesf?
If name m remd's d�Remnt Nan ihat of aPp5canl, md¢ate Delow
Name a mortgagee «cono-ad sene. G' /%�
��ir �
Address of mort9agee w mntracl seller (num6er erM sbee; ciry, state,
asvgnee w other owner w hdder of mwtgage
ary, sfete. and LP cade) p
/.� w .i .3 0
applirant am pmperty in any oNer
y�i��? ❑ Yes I
cCpn approved "c� Cre amwnt ot
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tt awned vriN someane
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9399
wnai r��q o'sm�rr
couNrr auoROrx
Za 2� _
Counry
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ts V�e ProPenY in ques0an:
�Real PmPeKY O A'
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v� u No
Drawer i\'0....�1�......
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Card NO. .... ��...........
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Date (mwCh. daY.
I I We certify under the penalry �pe�ury that ve antl foregoing in(ortnalion is true end cortect and that the app(�nnt is a resident of Ind�ana aM
owner I mntracl buyer of the afo�ementioned erry on date application is filed.
Slgrewe (ovmuS f� neme) Date (maafh. daY 1'a�
�(l�.[�,.,N-' e . �%Gt.c•-.a..-� —
FW resitlent sddress o1 appGrant (number arM sbee4 dty, state, eM LP cade)
,?o� s. 3�d /��zn�ct Huubs�u�( t-�N 9 763q
Person autMRed by dWy e.ew:e0 Paxer of AtOamY «M IC G7.7-�2-0.7 Date (mon�+.OaY• Y��
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