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HomeMy WebLinkAboutBallone, Kenneth and Carol - 16-10-29-01-04-005.000Office of the Clerk - Treasurer August 12, 2011 City of Carmel Hamilton County Recorder 33 N 9th St Suite 309 Noblesville IN 46060 LIEN RELEASE 2011039639 RELEASE $12.00 08/17/2011 01:42:12P 1 PGS Mary L. Clark HAMILTON County Recorder IN Recorded as Presented Illll I I IIII I I III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII The following lien for Barrett Law assessment recorded in 2001 for the Cool Creek North Subdivision, Instrument #200200085679, against the property listed herein opposite their name, of the City of Carmel, having been paid and discharged, such lien is hereby declared fully paid, satisfied and released this date. Name: Carol A Ballone Address: 552 Smokey Row Ct Carmel Indiana 46033 Total Paid: $813.75 Parcel # 16- 10- 29- 01 -04- 005.000 This instrument prepared by Jean A. Belcher, Deputy Clerk Treasurer �e� J Diana L Cord ray, Clerk Treasurer City of Carmel, Indiana,, ONE CIVIC SQUARE "I affirm, under the penalties for perjury, that I have taken reaso, . de care to r 'act each Social Security numb in ;' d1 , :, bylaw. (name CARTEL, INDIANA 46032 317/571 -2414 Office of the Clerk- Treasurer August 12, 2011 City of r Hamilton County Recorder 33 N 9th St Suite 309 Noblesville IN 46060 LIEN RELEASE 11 el 2011039639 RELEASE $12.00 08/17/2011 01:42:12P 1 PGS Mary L. Clark HAMILTON County Recorder IN Recorded as Presented IIIII 1111111 11 1 ID II IDIIIIII1111 IIIIIIIlII The following lien for Barrett Law assessment recorded in 2001 for the Cool Creek North Subdivision, Instrument #200200085679, against the property listed herein opposite their name, of the City of Carmel, having been paid and discharged, such lien is hereby declared fully paid, satisfied and released this date. Name: Carol A Ballone Address: 552 Smokey Row Ct Carmel Indiana 46033 Total Paid: $813.75 Parcel # 16- 10- 29- 01 -04- 005.000 This instrument prepared by Jean A. Belcher, Deputy Clerk Treasurer /(*-- )W Diana L Cordray, Clerk Treasurer City of Carmel, Indiana ONE CIVIC SQUARE CARMEL, INDIANA 46032 317/571 -2414 RECEIPT City of Carmel OFFICE OF CLERK-TREASURER Fund: 221 Barrett Law Fund Received from: ballone /delivered /jean For the Sum Of: Eighty One Dollars And Thirty Two Cents On Account of: barrett law /cool creek n Payment Detail: Check $81.32 Check #: ; Remitter Signature: Authorized Signature: FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 2009 33397 Receipt Date: 11/12/2010 $81.32 Office of the Clerk - Treasurer October 12, 2010 Carol Ballone 552 Smokey Row Ct Carmel IN 46033 CITY OF CARMEL BARRETT LAW DIVISION Parcel # 16- 10- 29- 01 -04- 005.000 FINAL INVOICE Cool Creek North FINAL Installment $81.32 Our records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The final annual payment is due by 11/10/2010. Please make your check payable to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2010. ® w® 4,t9 ®® 71 -1 -863 Garol A. Ballone 552 �mokey Row Ct. Game!, IN 46033 d/ /e ' i //O f / ,'«t carte / rtr lau) a✓ $ p, 3L ,y ,, OLD NATIONAL BANK ,,,...�t ® ® \ O'er gt # cti Office of the Clerk - Treasurer City of Carmel October 12, 2010 Carol Ballone 552 Smokey Row Ct Carmel IN 46033 CITY OF CARMEL BARRETT LAW DIVISION Parcel # 16- 10- 29- 01 -04- 005.000 FINAL INVOICE Cool Creek North FINAL Installment $81.32 Our records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The final annual payment is due by 11/10/2010. Please make your check payable to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2010. Sincerely, Jean A. Belcher (317) 571 2427 REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 317/571.2414 Fund: Total: For the Sum Of: Received from: On Account of: RECEIPT 220 Barrett Law Fund CITY OF CARMEL OFFICE OF CLERK- TREASURER $81.39 Eighty One Dollars And Thirty Nine Cents ballone /mail barrett law /cool creek n Payment Type: Check Remitter Signature Authorized Signature 11/17/2009 FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 1989 26811 Office of the Clerk- Treasurer October 2, 2009 City armel Carol Ballone 552 Smokey Row Ct Carmel IN 46033 16- 10- 26- 01 -04- 005.000 Dear Sir or Madam: 1008 NOV 13 P 3: 55 CITY OF CARMEL BARRETT LAW DIVISION INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2009. Please make the check payable to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2009. You may at any time pay the entire balance. COO aZ° 71 -1.863 ©� Carol A. �,allone Carmel, IN 433 3047 OLD NATIONAL BANK v. __ 45036900170 0 30' 7 r'214 ` �Q c°"° °: °" Ddb 4°p _ 'err �l14 TM 9� ei &os En-ertzmment. �rc ls0e) — � `©' Office of the Clerk- Treasurer October 2, 2009 City of C r Carol Ballone 552 Smokey Row Ct Carmel IN 46033 16- 10- 26- 01 -04- 005.000 Dear Sir or Madam: CITY OF CARMEL BARRETT LAW DIVISION INVOICE 1 l l e Cool Creek North Annual Installment .$81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2009. Please make the check payable to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2009. You may at any time pay the entire balance. Sincerely, Jean A. Belcher ONE CIVIC SQUARE CARMEL, INDIANA 46032 317/571 -2414 Fund :1 RECEIPT CITY OF CARMEL 220 Barrett Law Fund OFFICE OF CLERK - TREASURER Total: $81.38 For the Sum Of: Eighty One Dollars And Thirty Eight Cents Received from: ballone /mail On Account of: barrett law /cool creek n Payment Type: Check Remitter Signature Authorized Signature 11/10/2008 FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 1989 25449 CITY OF CARMEL BARRETT LAW DIVISION 10/08/2008 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood.The next annual payment is due by 11/10/2008. Please make the check payble 1 TN CAROL A BALLONE 06/06 552 SMOKEY ROW CT CARMEL, IN 46033 i to the ler of a Charter One 15/c( Date 497 6- 7041/2410 ramie.L 6GUr ir)Aki raw I $ s7,3? - 33 /foJ Dollars r 6-re-e6LiDa02 329 Delmit on Beck : 04 9 7 e, Carmel, Indiana 46032. . You may at any time pay the )PY tren Huffman (317) 571 -2427 CITY OF CARMEL BARRETT LAW DIVISION 10/08/2008 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Carol Ballone INVOICE Cool Creek North Annual Installment 581.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood.The next annual payment is due by 11/10/2008. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2008. You may at any time pay the entire balance. REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 CITY OF CARMEL BARRETT LAW DIVISION 10/17/2007 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Carol Ballone INVOICE Cool Creek North Annual Installment 581.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood.The next annual payment is due by 11/10/2007. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty_ A • 71-65/749 Y5any time pay the 0010138086 1 >2 0°2'424 First Merchants Bank w. a www.tstmerchants.com " ''` L rw ry `q 7) 571 -2427 _: 0)olPars seacav pa. on CITY OF CARMEL BARRETT LAW DIVISION 10/17/2007 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood.The next annual payment is due by 11/10/2007. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2007. You may at any time pay the entire balance. REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 I CITY OF CARMEL BARRETT LAW DIVISION 10/17/2007 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 0 Dear: Carol Ballone 0 INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood.The next annual payment is due by 11/10/2007. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2007. You may at any time pay the entire balance. ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 Fund' RECEIPT CITY OF CARMEL 220 Barrett Law Fund OFFICE OF CLERK - TREASURER 11/10/2006 Total: $81.38 For the Sum Of: Eighty One Dollars And Thirty Eight Cents Received from: ballone /mail On Account of: barrett law /cool creek n Payment Type: Check Remitter Signature Authorized Signature FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 1989 22806 CITY OF CARMEL BARRETT LAW DIVISION 10/18/2006 Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: ICIMMiCarol Ballone INVOICE Cool Creek North Annual Installment 581.38 110 City's records show that. you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2006. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2006. You may at any time pay the entire balance. REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 to- �; � ,...�jjj�� //t pf�'.�' demo • 10/18/2006 carol Ballone 552 Smokey Row Court Carmel, IN 46033 2 3 2 CITY OF CARMEL BARRETT LAW DIVISION ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: IMINIM.CarolBallone zao-e VLa-IU'_ i3/ INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have a reed I.o make' 10 annual installments for the Barrett Law project in your neighborhood. The next annual-payment is due by.-11/10/2006. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2006. You may at any time pay the entire balance: REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 RECEIPT Fund: 220 Barrett Law Fund CITY OF CARMEL OFFICE OF CLERK - TREASURER Total: $81.38 For the Sum Of: Eighty One Dollars And Thirty Eight Cents Received from: ballone /mail On Account of: barrett law /cool creek Payment Type: Check Remitter Signature Authorized Signature 21491 11/10/2005 FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 1989 CITY OF CARMEL BARRETT LAW DIVISION 10/04/2005 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2005. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. entire balance. ONE CIVIC SQU • • CITY OF CARMEL BARRETT LAW DIVISION 10/04/2005 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment S81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2005. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2005. You may at any time pay the entire balance. REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 CITY OF CARMEL BARRETT LAW DIVISION 10/04/2005 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2005. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Cannel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2005. You may at any time pay the entire balance. ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 Fund: Totzt,: RECEIPT 220 Barrett Law Fund CITY OF CARMEL OFFICE OF CLERK - TREASURER $81.38 For the Sum Of: Eighty One Dollars And Thirty Eight Cents Received from: ballone /mail On Account of: barrett law /cool creek Payment Type: Check Remitter Signature 020222 11/10/2004 Authorized Signature FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR THE CITY OF CARMEL - 1989 CITY OF CARMEL BARRETT LAW DIVISION 10/05/2004 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2004. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoi entire b ay the KENNETH BALLONE CAROL BALLONE 552 SMOKEY ROW CT. CARMEL, IN 46033 ONE CI FIRST INDIANA. BANK INDIANAPOLIS, INDIANA 46204 ,. MONEY TALKS...MINE SAYS GOODBYE! 2427 CITY OF CARMEL BARRETT LAW DIVISION 10/05/2004 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, N 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 1 1/10/2004. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2004. You may at any time pay the entire balance. REMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 CITY OF CARMEL BARRETT LAW DIVISION 10/05/2004 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, N 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2004. Please make the check payble to the City of Carmel Barrett Law Division and send to Once Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2004. You may at any time pay the entire balance. ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 CITY OF CARMEL BARRETT LAW DIVISION 09/25/2003 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone INVOICE 1J EN= Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2003: Please make the check payble to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2003. You may at any time pay the entire balance. EMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 s CITY OF CARMEL BARRETT LAW DIVISION 09/25/2003 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: Parcel #: 16- 10- 29- 01 -04- 005.000 Dear: Kenneth & Carol Ballone Cool Creek North Annual Installment 7 INVOICE $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2003. Please make the check payble to the City of Carmel Barrett Law Division p yb e and send t send the enclosed REMTTT • tvrF, cr I r :a, to One Civic Square, Carmel, Indiana 4b032. Please - 4•F»`i'L�3 � <.v'n�4.fn= 5v- n"rnu %���%'� - To avoid a penalty, youp entire balance. ONE CIVIC SQUARE CITY OF CARMEL BARRETT LAW DIVISION 09/25/2003 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, IN 46033 ID: 7 Parcel #: 16- 10- 29- 01 -04- 005.000 iti) Dear: Kenneth & Carol Ballone INVOICE Cool Creek North Annual Installment $81.38 The City's records show that you have agreed to make 10 annual installments for the Barrett Law project in your neighborhood. The next annual payment is due by 11/10/2003. Please make the check payble to the City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed REMITTANCE COPY with your check. To avoid a penalty, you must send your payment no later than 11/10/2003. You may at any time pay the entire balance. ONE CIVIC SQUARE CARMEL, INDIANA 46032 Karen Huffman (317) 571 -2427 3r 7, 2002 nth & Carol Ballone rokey Row Court Indiana 46033 3- 10- 29- 01 -04- 005.000 :enneth & Carol Ballone, I N V O I C E :reek North Light Project 2nd Payment $81.38 !8/01 you paid the amount of $81.38 and agreed to the10 year payment option for the Barrett ssessment in Cool Creek North. The 2nd annual payment is due by November 10, 2002. make the check payable to The City of Carmel Barrett Law Division and send to One Civic Carmel, Indiana 46032. Please send the enclosed yellow remittance copy with your REMITTANCE COPY ;IVIC SQUARE CARMEL, INDIANA 46032 317 - 571 -2427 October 7, 2002 Kenneth & Carol Ballone 552 Smokey Row Court Carmel, Indiana 46033 CITY OF CARMEL BARRETT LAW DIVISON Re: 16- 10- 29- 01 -04- 005.000 Dear Kenneth & Carol Ballone, I N V O I C E Cool Creek North Light Project 2nd Payment $81.38 On 11/8/01 you paid the amount of $81.38 and agreed to the10 year payment option for the Barrett Law Assessment in Cool Creek North. The 2nd annual payment is due by November 10, 2002. Please make the check payable to The City of Carmel Barrett Law Division and send to One Civic Square, Carmel, Indiana 46032. Please send the enclosed yellow remittance copy with your check. EMITTANCE COPY ONE CIVIC SQUARE CARMEL, INDIANA 46032 317 - 571 -2427 Barrett Number: CCN -001 Resolution Number: BPW 06- 06 -01 -01 Property ID: 16- 10- 29- 01 -04- 005.000 Barrett Law Installment Schedule Year Principal Interest Total Payment Due Date 1 43.36 38.03 81.38 11/10/2001 2 46.17 35.21 81.38 11/10/2002 3 49.17 32.21 81.38 11/10/2003 4 52.37 29.01 81.38 11/10/2004 5 55.77 25.61 81.38 11/10/2005 6 59.40 21.98 81.38 11/10/2006 7 63.26 18.12 81.38 11/10/2007 8 67.37 14.01 81.38 11/10/2008 9 71.75 9.63 81.38 11/10/2009 10 76.37 4.96 81.33 11/10/2010 Make checks payable to: City of Carmel Barrett Fund. WAIVER OF PROPERTY OWNER If you wish to make 10 annual installment payments, one -tenth of the assessment plus interest to the annual due date will be charged (see chart above). If this is your choice, please sign the "waiver" , notarize signatures, and return in the enclosed self addressed envelope with the first payment. ` Signature: Signature: Installment notices to be mailed to: Pray to Stop Abortion! American Life League, Inc., Stafford, VA 22555 Mr. Kenneth Ballone 552 Smokey Row Ct. Carmei, IN 46033 Subscribed and sworn before me this 31 day of J' C) 20 f . a�LyD 5, 1Aasu.E1- J , Q� PRINTED NAME OF NOTARY NOTARY'S SIGNATURE l fil lfL , My Commission Expires , d6‘' COU Y •F RESIDENCE s The gift of God is eternal life. - Romans 6.23 ICU V3`L,Y °.'a7Vaii ze-' 9loru 6 '46b3 20- 7043/2740 4 7 1 8 Date /! $ 7/,3R Dollars FIRST£' ,1 CIANb►4BANK 41NDUtNAPOIIS -, IN IAN" 46204; :• r: 47 L8 TO REORDER 1•90O204.224d• wow Chock ellniondeE com