HomeMy WebLinkAboutMortgage_Moody^�n4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year �
_,_ � FOR DEDUCTION FROM ASSESSED VALUATION
� • Slate fortn 43709 (R71 / 6O9)
S,� e p��'yyd 6y DepartrtreM af Local GavemrtreM Frurce
File Mark
INSTRUCTIONS:
To 6e filed in person w by mad wiM the CowrtyAuditor or Counry Recorde� o/ Ne tounry where the property is Iocated. m���
Fding Dates: i) Real Property: Must fi!e dumg Ne year Por which the deduction is sought.
2) Mo6de / Manufactured Homes rmt assessed as Real Pmperty: Must file during the hveNe (12) months -
6efae Ma/ch 31 of each year Ne deduUion is sought ❑.County Recorder
Sea reverse side /oGBdditional instrucGons arM qualifiptions. ,
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ro,
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If name on remrd is S�Resent Nan that ot aDP��t hidipte bebw
rlame ot morlqasee «conrrar�
pddress
othu owner or hdder of
slate.
Addmss of as99nee (numberaM sbee4 Nry, sfafe, eM LP coda) - — —
Does ePplitant wm property in any oNer .
tounry in Indpna?
❑ Yes ❑ No DI'�11'CI' 1TO.......I...........
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or equitade ownrl7
❑ Yes ❑ No
Is the property in Questlon: MnuaDy Pssessed
❑ Rea� a�or�enr � annuaiy a�
3s Nis Oetluction been requested m proprily
r arrent yeaR n Yes ❑ No
zo_ � zo_
rEed
I I We certfy u�er Ne penatty of perjury ihat the above and foregoing intortnation is We and corteU arM that the applicant is a resident of Indiana aM
o.mer I contrad buyer of the aforementioned property on date appliralion is filed.
state,
auNorrseE Oy OiEy ezeatetl Power ol Attcmey w by �C G7.1-12-0.7
Pdd2a of auCmr¢etl prlson (numDerantl sbeeL �1; s+ate, antl
Date (monfh. deY.