HomeMy WebLinkAboutMortgage_Mowrer (2)�"n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ � FOR DEDUCTION FROM ASSESSED VALUATION
` ..• SU[e Fortn 43709 (R71 / 609)
� i p��'p� py pepaMreN af LocW GmemmeM Frunce
File Mark
INSTRUCTIONS:
To be fifed in person or by mai7 with the CountyAWitor orCounry Recorder o/ tAe county where fhe pmperty is bcated. Fam med with:
F7ing Dates: 7J Real Prope/fy Must fJe during the year for which the deduclion is sought � County Audimr
2) Mo6Ae / Manufactured Homes not assessed as Real Praperty Must file dunng the hveNe (12) months
befae March 31 of each year the deduction is sought. ❑ Counry Recorder
See reverse side !or adtlitional instrucUons and qualiflcations.
AooGant (oumi,or mnt[aC buv�- see restnUions m rererse sidel
As�ed rahre of mal p�operty as W
Matd� 1, arrent year
Ii ro, what is his ! her eraa share oi intrlesCl
rc rerne n,.emta a d�nnerent u�an
liame ot mortga9ea w mntract seAu
Mw�age
Mard� 1.
a/
unpaid as of
w mntract se4er (num6er and sheel, ciry, state, aM LP coda�- --
Name of assignee w oNe� ownet or hdder ot mortgage
ALEress o( asq9nee (number ard atreet �N: s+afe, end LP wEe)
Oces epp&ant wm pmperty in any oNer If yes. w1�
munry m Iridiara? ❑ Yes
❑ No
DeEuction app�m�ed'ui �he amwnt of:
20 _ 20 _ 20 _
Remrd num6rl
cMe6tednass unpaid as d
sPaae�
iitade avmeYt
Yes ❑ No
Is IM P�Gert1' in Our.tion: MnuaM Pssessed
❑ Real aroa�v ❑ ��M�
Mobile Home (IC 6
�`�' `� � ��
Dra�� er i�0. 01013.........
�uesteE m P��RY
C11'(1 �i� . ..................... � Yes ❑
COL... . ..
20_ 20_
��b
20 _ � 20
Date (month. daY•
I I We certfy under the penalry ot perjury that the ahove and foregoing infortnaGon is true end cortect arM that the appiicant is a resident of Indiana a�
owner I contrad �uyer of the aforementirned property on date appfication is filed.
�f¢G�re ( e!: narye) � / . Date (nmtA, daY. Y��
LP Catle)
auttw'm.d Dy dUy emated Pawer af Auorney or Gy IC 67.7-12-0.7
pelmn (numDer antl sbcef, ury, s7ale,