HomeMy WebLinkAboutMortgage_Beasley (3)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
s�ea �m aa�as la�o n,oa�
ti � Prasrn'bed by DeQaManf d Loml GovammeN Firen�
INSTRUCTIONS: Fi�e Mafk
To 6e filed in person or 6y mail wiUr fhe Ca�unlyAWitar o/ the cnunty where fhe property is located. J U N 2 9 2 � �9
Filiig Dales: i) Real Pioperty: Musf fJe dunng fhe year /or which Ne deduction is sought.
2� Mobde / MarnAacWred Homes not assessed as Real Property: Must file tlun�g Me lweNe (12J months before Merch 31 0! each year
fhe deduction is saight `–y�� � v�
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See �everse sOe /ar a0ddional insWCtions aM qualificetians.
�wa�"*'o'a' w"�'aS� ��'P- see reesbwie�ons m mwrm sde)
MaRI� 1, amartl yaa
tl ro, whal p hi5 / her erarl shara ot iMamsR
If name on iewd is d'MareM than Ihat ot
:T.ui i
" U— - UU— /, y'
nrortaage� c«nraa weeaeaness �a a: a nai
Mamli 1, curreN yaar date
If rnvned Mrit�:
Nrt�eC aN. �4 ar�dZlProdo)
Name d assignea w olher owner u hdder of moAgape
IPddress d asipnee (mur6ei an0 sbnd. a7Y_stabi. aM
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_ ��- au�9
wn� r��e o�smc
COUNTY AUDITOR
zo �
I legai or eqv.�ble onieR
❑ Yes ❑ No
wNh r�hom
b e 0�7aRY in quastim: MnuaOy Auesse0
Real Property Q Mnualy AssesseC
Has Ws deduGian been requested on pfopeR/
br artent yeaR -
❑ Yes ❑ No
20 � 2�
Si( _.,,.,.,var � I�• J. I CaunN � oate (mmN. daY.Y�)
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I/ We certify urMer Ne pen Ity af peljury that ihe above an0 foregoing 'vifartnation is We and corred anC that the app6can[ is a resiamt af Indiana aM
owner / coniracf buyer oF ihe aforementio�d property on date applxa6on is filed.
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FWlresiEentaECres nt(nunAVardsberl.�}: fo.ardLPwde)
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