HomeMy WebLinkAboutMortgage_Hoefling�`
'°n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
y'-'•:
; FOR DEDUCTION FROM ASSESSED VALUATION
State Form 93709 (R71 / 6-09)
� '� PreuriEed by Departrtrenl of Lool Govemment Frence
�«.
1
INSTRUCTIONS:
To 6e hTed in person or by mail with the CountyAuditor or Counry RemNer of the county where the propeRy is focated. � l
Fil'ug Dates: 1J Real Property: Must fi/e during fhe year /w which fhe tleduction is sought.
2) Mobde / Manufactumd Homes not assessed as Real Prt�perry: Must h7e dunng the fwelve (72) months C
6efore March 31 of each year the deduction is sought. GM�
See reverse side /or additional insWCtions and qual�catrons. �6$. � �J�"� �O1
Ap carn (°�' or crntract buyer- s e resfnnct'nns on reverse side) 1� j
�w, bP.r �1 �or+i � i�1c, d �o� v l7 SG�1l)Q,U.�Z
��onaDutrict Kevnumber/leoal esaiotion REv
I vaAie d real property a of
va e
avmnc year
exatl share of interest?
0
1
AdCress d matgagce or oontrad se�er (numher �d6tree; ciy,
I�- Q8 E' (Z� v S
Name o( assvyiee or other ovmer or hoiAer of mortgage
poperty in any oNer �j-�� If yes, what
❑ YES I!!� No
�� "V
0
Oate
�
Counry Autlimr
C�unN Recorder
1s �he aCd'�nt Me sae
legal « equrtade ame/?
❑ Yes ❑ No
tt aM+red wiN someane other Ihan spasse. intlicate with vRnm
ry in auestion: M(waDy Psse55e0
�-d� ProaerH ❑ /wwalN 0.ssessed
Ta�dn9 DisGitt? Has Nis deAUrbon Deen reGUested m P�openY
far artent Year? ❑ Yes ❑ No
� \\ GOUNTYAUDROR
DeQumon aPW� m tlie amouN of: �
�.
20 20 20 20 20 20 20
Sig�tlne of c',amty Aueilor Counry Date (mwth. daY 3��)
I/ We certify under Ne penalty of perjury Mat the above arW (omgmng mfomiaGOn is We and cortert arM that the appiinnt is a resident of IrWiana and
owner / contracl buyer of �he afwementioned property on date appfuation is filed.
" renue owne/s hA ) Date (mw#A. daY. Y��
'�F aEtlress appGmntlnum6eiaMStreet.tlty, .aMLPaotlej
r
�I Z S S W Q.w S C
Pason author¢ed M d�iy exe`vtetl Power of PuameY M�c �-i-iz-u.� .. . oa�e �mornn. ear• r�
Pdd� d aWw�'ned pefsan (numbera� stree; tlty, state, antl LPmde) .