HomeMy WebLinkAboutMortgage_Earle.>°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Townshi Year
.__ FOR DEDUCTION FROM ASSESSED VALUATION � �
Slate Fam 43709 (RS / 2-07)
S; 1 Resrnbed by Department ot Local Ga�emment Finance �
iNSrnucnoNS: qPR S F��`�`
To 6e fifed in person or by mad wdh the CountyAuditoi of the county wheie fhe pmpeAy is located.
Fding Dates: 1) Real Property: Dunng the 12 months before June 11 of the }rear fhe deduction is fo be elfecbve. „ i/
2J Mobile Homes assessed under IC 6-7.1-7: Beh,vaen January 15 and March 2 of the year the deduction��f%�S�g •
See 2verse sida for additional insWctions and qualifications. U
r_�ncnN COUNTY AUDITOR
4ppican me`ormMiaCbuyer- e n ,
(.�/
r � o��a Key numbei
Assessed value of real P�P�Y as d Mardi 1. aarei
If �r what is his I ha exaG share of inteiest7
If� m recwd is dA(erent Uan Ihat of applicant
Name of mortgagee or cage{aU sdler �
raverm sde)
y�p�n Reoortl number Page number_
_ 03 .�o-ooG o , -oor �-��g �o.�
Mor�gage / Coniract irWeMedness unpaid as of March 7, Is Ihe app6pnt Ihe sde legal or equitade wmeYl
aR�l� S
3� , Qy ❑Yes ❑No
If ownetl wilh someone dher Ihan spwu, ir�dicate with whom.
below: Is Ihe property in questlon:
❑ Real Pmperty ❑ Mobile Home (IC 67.1-7)
Address of mo�gagee oriSnVad sell�(numbu aiM 9reef. tity, state, arM
Name af assgnee a all�er owner w hdder of rrwrt9aga
asvgnee (mim6er aiM sLeel.
Doas applicant wm property fn a�ry olher
ca,�ry in �naianaa
❑Yes ❑No
Deduciion approved in ihe amount of:
1 �1 �
ZIP wtle)
If yes, whal wunly? Whal Te�dng DiSUic
COUNTYAUDROR
2p _ 20 _ 20
DYa��'CI' �i�..ad �%�tl.:...�./ D.S
C�t'd �'�. .. .:�.....
'�a� '�'' �� - S"s� 3/�l; o0
20 � 20
�naWre of CaunryP.uCimr `„ 1 I� I Caunty Dafe (month. daY.Y��
0 �
F
I/ We certify under the penalty of perjury that the above and foregoing infomiation is trve and correct and that Uie applinnts was / we2 a resident of
Indiana and owner of the atorementioned property on March 1, 20
,�dml a� s of applitanl (nvmbei and street dt . sfate, aM ZIP mde)
/ f /�e�' l 7<i� �r�Jr7'<
Pason authorized by duy a<ecuted Power oF Nlaney w by IC 61.7-12-.07
pason (numberaMs4ee;aty.state.
�
Oate (monfh, day, yea�