HomeMy WebLinkAboutMortgage_Stiles (2)^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ _• FOR DEDUCTION FROM ASSESSED VALUATION
� State Fortn 43709IR11 / C+09)
�' ,,,, Presaibe0 by Departrt�eN af L.ocal C»vemmeni Fuarce ..
File Mark
INSTRUCTIONS:
To 6e filed in person w by maii wiN the CountyAUditor or Counry RecoNer o/ the county where the pioperry is located.
Fifirg Dates: 1) Real Pmperty: Must file dunng fhe year (o� which the deduction is sought.
2) Mo6Ae /ManWactured Homes rrot assessed as Real Property Must file dunrHj the twelve (12) monfhs
bePore March 31 of each year the deduction is soughG �
See reverse side /or additionel instnictaons arM qualfirafions. G I BSOI
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Ma�di 1. a+mnt War
�I no, whal k h's I Mf e�or� share OI Ntrlest7
i IIM�¢ IXI ICWfd
Counry Auditor
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MortgaBe / Contrac[ indehtetlness unpaN as W Moriqaga / Con7aU irMeMedness unpaid a o! Is Ne appOrant the sde
Mam7� 1, wrtent year date of appGcation legal d eQWtade owne(/
Q (�Q Q ❑ Yes ❑ No
N owned wiM somrorie oMe ihan sP��. iMkate with wRwm
. �Mlfdif GCIOYf. IS P2fl`f Ifl QIIPSbOfI: MIIU'dq'ASSGSSEd
Real Rvperty ❑ Mnually Asszssed . . _
of rtartga9ce or mntraa se�er (nuMer end sveeG �}: s�, arN LP rode)
Name of assignee or other ovmer w Iwlder af �mrtgage
AAtlress o� assignce (number eiM street tlry, state,
any
D�uction approvad 6� Ihe amounl of.
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COUNTVAUDROR
2�
Counry
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- 5351
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� oa�e (mmm. aa�: r�n
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I/ We cerOfy under Ihe penalty ot perjury that the ahove and foregoing infortna6on is true and cortect arM Ihat fhe appfuant is a resident of Indiana aiM
oxmer I contract buyer of the aforemertGOned property on date appliqtion is filed.
� Sigrenue (owners hm rreme) , Date (rmrvM del: Yaer) ��
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F W revtlent adGess
Pe�son au�haaed Oy
(numDer an0 stree4 rnY. state, and LP ootle)
or by
person (number arM stree4 �+N. sta[e. and LP cnde)
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