HomeMy WebLinkAboutMortgage_Hardin"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tawnship
_„ FOR DEDUCTION FROM ASSESSED VALUATION
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File Mark
INSTRUCTIONS:
F
b ba �ded in person a by mail wifA the County Auditor or Counry RecoNer ot Ne counry whe2 fhe property is located.
Fding Dates: 1J Real Property Must fife dunrg Ne year for which the deductbn is wughG Counry Aud'rtor
2) Mobde / Manufactured Homes not assessed as Real Pmperty Must fi/e dunng the hveNe (12) months p�/ /�
6efore March 31 of each year the deduction rs sought. K-16�9�mY �
v
See ra side !or additiona! instn¢t�ons araf qualfications. GI
Appfifant ar� C buye�- see m�'`� m re sitle)
1 i///�Y� r7C /� A.[ �Q 1 nL)
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e! Contraa u
a�rmntyear
n ro. wnat s ns � tcer eraa snere m intsest't
If nama on �emttl s QAferen[ Nan thal of app6mnl, tr�d'uate bek'w:
Nama of rtort9a9m ar cono-act seau / n^ ^�
/
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Address of �agee or oontraU seder (number and stree4 � ste�.
Name al assynea or oNer ownet or hoWer ot mortgage
AilCrass ot av9gnm (num6ei arM sbee4 a+y. stafi, end LP code)
Dces appliranc awn prapem/ in any oMer 1f yes, wlu
munry v� Indana?
❑ Yes ❑ No
DMUCtion apWO+eE c� Cre amount of.
20 � 20 _ � 2t1
21
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sig(aene w cauib nuaitor
� I/ We certify u�er Ne penalty1 f perjury that the above and forego
owner / mntract buyer of Ne atwementioned property on date appli
` I S�Brenue ( +�rr�e)
.�
�
.` FWI 2vtlen[ atldr�s� pf a rcant (numOer ard t, cily, state, and ZIP oode)
.�\ � / �
/ i
lray �ea,�a arn.v orwramer « M �c
Gersm (number and street �Y. sfa[e. a
20 _
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Igaqe / Conract'vMebteAness unpaid as W Is Me epp(ont the sde
� of appfrc-etion � a equitaNa owr�l�
.3� (�O ❑res ❑ No
someone other ihan spouse. IMicate wiN whom
h property in Question: AnnuaDyASSesseO
Real a'oaenv ❑ /+��M �
�S L.� .3a . 3 - `1 . �o �e.
Nhat Tari(g Distria? Has ihis deductim Deen reGUested m P��Y
far a�ren1 Y�r? ❑ Yes ❑ No
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