HomeMy WebLinkAboutMortgage_Meny (10)'° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
___ _ FOR DEDUCTION FROM ASSESSED VALUATION
� s�e �„ as�os crx„ � s-a9�
�' ,,,, PrescibeE by DepartmeM of Lo� Govemment Firence �
a
wsraucnoNS:
b be filed in person w by mad xiN the CounryAuditor or Counry Recoider o! the county where the {woperty is located.
FiHrg Dates: 1) Real Proparty: Must file dunng the year fir which fhe deUUCtion is sought.
2) Mu6de /Manufadured Homes rat assessed as Real Property: Must file dunrg the twefve (72J months
6efore March 31 oi each year the deduUion is sought.
See 2verse side for addrlional inshuctbns and qualifications.
M7��'%Yownarwcon7raCbN'�'seeresbic8orumreversaside) n L.
Counry Auditw
T' istri� (/ Key ram6er / 1e9a1 d ' Reard numDer Page wmbnf
al��ao- a - aa-000. �d--oo 2-00 �37 ;
Asesssd va4ie oFre� VoP�Y as of Mw�ag e/ Contract irdeWedness unOaN as W MoRgage / Can:recl'vWebtedness un0� as o! Is Ihe app5rant tlre sde
Mairh 1. a�V year March 1, airtgnt year date of appGtation kgal a equdade wme(?
U� /1/l /1 n Yes n No
If ro. what fs his l im e�ct snare of intuesCl
�me m remfd'o Qf'erent
Nartre
AEArea d rtcrt9a9ce or mntracl sWcr (nurt�ber end streeG U
Name of asi�ee v othr+awner or hdder af mortgaga
Address o7 assignee (number ard sbee; tlry, swe, a LP a
T
Does appikant rnm property in any olher If yes.
munry m Indiar�a? (� Yes ❑ No
ccon app�oveE in Cre amount ot
20 _ 29 _ 20 _
I/ We cerGfy unde(Rie penal
owner / mntract buyer o( Ne
� , �� �
ent W appGrant
� O5 — io i
_ PeF.,on authomxtl Oy Culy execut
tl owned wiN wrtreone other Nan sWuse.
IS Ne WoD�Y in 7ue51ion: MnueDy AssesseE
[�.Real Properry ❑ Mnually Assessed
j � �c� R �-� A (l'��-1� �I
—�m m,y s
���q — (� 3�1 �
thai the above and foregoing intortnatlon is We and mrtect arM that ihe applirant is a resident of Indi2na a�
ned D�DenY o� date aPPlication is filed.
Date (rtarW. deY.Y��
tiry, state. ard ZfP oode)
(numDar an0 sfreeG �: sbte. eM ZIP mde)
oa�e (�,a,m, aar. r��