HomeMy WebLinkAboutMortgage_Gonyer""� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ovmship Year
_,. • FOR DEDUCTION FROM ASSESSED VALUATION ��
� State Fmn C3709 (R77 / 6-09)
S,,,, � P�esrnbed M DeP�ment af Loral Govertvrient Frianca
File Mark
INSTRUCTIONS: ��(` p �f1
To be fi(ed in person w by mad witA the CourttyAuditor or Counry Reoorde` o� the county where fhe�pwper� i@ E7c�t�. F� �� �'
Filing Dates: 1) Real Pmperty: Must file durirg the year lor which the deduction is soughG " unry Auditor
2) MobRe /Manufactured Homes rrot assesced az Real Properly Must fi!e during M�'fw� s
6efore Ma�ch 31 of each year the deduction is sought. � ❑ Counry Remrder
See reverse side foradditional instrucWns and qua/fications. AUDITOR
MP�t ( � �°A�bN'�:.�
_ ,
0.s�e va ua d� �C�Y f Mamh 1 ewrt�enf
Meidi 1. nvrent
If ra, what is his / her eraU share o( intcresi?
It name m 2mN a dRUent lhan ihat ol aPP��L mdinte below:
Name at moM9a9ee or contraU se9er !` 1
w othel owner w tmldu of
PdCmss of asag�e (nun�i eM street �l% state, erM
-�:�.�a-aai ._�..a.�.. a ����6
�ness unpaid as af Mort�age / Con•,rac[ mAehtedness unpaid as of Is the eDP�t the sole
�y� date o( appacatbn legal or equilaWe amrY1
�J O ❑ Yes ❑ No
�Mm. aM7JPoode)
Dces ePPli�ant rnm pmperty in eny other I If yes. wha[ munq? I What Tapng
munry m Ind�ana? r-� .. r-� ._
someane other ihan spouse. hdicate wOh wfwm
Is ihe property in questim: Mnua�y ASw,seE
� Real RoPenY ❑ %�b �
� P��P�'+�Y
❑ No
�i d �% � �. ". � /�I �� � COUNTY AUOROR
C� J✓ci��Y�t
� 10�� $�. °o
Drawer NO...... aQ�.... zo zo_ zo zo_
j� 1'7 � ca,�y oa�e y�nn,� �
Cal'd �`O. .....u!�,/........ �d �o+
Foregoing information is we and cortect arM that the applinnt is a resident of Indiana aM
owner I contrad buyer of the aforementior%d� roperty on date applintion is filed.
3nacu2 MI rmme) Date (mwRh. daY. We�
J
Pert,on auNw'¢ed Gy dWy
ol Attnrt�ey or by
Gn+son (num0erarN sbaet �: staM. end LP code)