HomeMy WebLinkAboutMortgage_Walker (9)'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
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a FOR DEDUCTION FROM ASSESSED VALUATION
State Fom 43709 (R71 / 6O9)
�' ,,,� 1 Presrn"betl by DepartmeM oi Lafai GovemmeM F�ncc
File Mark
wsrRUCnoNS:
F 0ed� '
To be filed in person w by mai7 with Ne CowlyA�ditor or Counry Recader of the county where the pmperry is bca d.
A3rg Dates: 7) Real Pmperty: Must file durimg the year for which Ne deduction is sough[. y/, ' r
2J Mo6ile / Manu/actured Hwnes not assessed as Real Property: Must file dunng the tweNe (12J months
before March 37 of each year the deduclion is soughf. � � County Recorder
See reverse side for additional instrucfions and qualifiwtions. �
42a1 P�Y�
S�
share of infrlest?
n��i � aa
arrent year
If narne m �emtl's 6flemnl Uwn Nat of app6ran4 bdiraie belo�'.
Name of rtnrtgagee or contraa
u..S 0 �
������.
a mortgage
(numDer aM streeG d1}: stete. eM LP oode)
di�ant wm yope�ty in any dher
IMYana?
❑ Yes
Or�ucUOn approveG in ihe amount
20 I 20
Sig(aRire
I! yes. Mut
�
_�{-0 3_ o oj. � y�_o 1.8 ci�S6i�1"�Yi'I
de6tedness unpaid az ot Mortgage / ContraG indebteMess unpaid as W
dateo/ao0�� _
20
H ow�d wiM mmeofre oNerthan spouse. iMkafe wtth whom
auoRc
Yes LI No
Is IM D�DenY in 7uesUm: Mfwa%ASSesseO
❑ Reai a�oaero ❑ am,�y w�d
Modle Fiome (IC 61.
� � ��„a,.n,��'4..r - —
� �OI � � • —
pl•a��•er i��•... ... .....
;';,.•••.•........• �No
Card `o•� •�� 591. `= —
20
�
Date (monlh. daY• Y��1
20
1 I We certify under ihe penalry of perju(y Nat the abo�nd foregoing infortnation is we and cortect and that Me appiirant is a resident of Indiana ard
owner I wntrad buyer of the afaementbned prope n date applidtlon is filed.
�re(owne�` 7W� name) Date (mon�. EaY• l'aa�)
,�I�N�L7/
F " en� t addrass of appfi�nl (numDer enE 4�: �te, and LP cotle)
b o26 .S. Se .�t %na.r S� 1-�r i � �o �7 (� }70
Pgson auU�o�aeE Gy dWy ezewce0 al AttomcY ot by IC E1.1-12�.7 Date (monN. daY Y��
AdCress of authw'ved permn (numbera� sLee; ary. sfate. end LP wde) .