HomeMy WebLinkAboutMortgage_Minton^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship vear
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= FOR DEDUCTION FROM ASSESSED VALUATION
� • Slate Farm 437091R11 / 6-09)
�� 1 P�esaibed by DePe�ent of local GwemmeN Frenca
..�STRUCTIONS: [�p y�n
To be filed in person w by mail with the CountyAudito� or Counry Recorder of the county wheie fhe property is Iorated.MAR Lr V I C�
Filing Dates: 7) Real Pmperty: Must file dunng the year (or which the deducfion is sought. � County Audimr
2) Mo6i7e / Manufactuled Hortres rrot assessed as Real Properfy Musf fife dunng the lwelve (12J monNsC � ounty Recorder
6efore March 37. oi each year the deduction is s0ught.
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See reverse side 7a add'tional instrucfnons and qualifications.
AoNra (ownermcanfractbuyer-sreras4{cj�auanreverseside) � . • . . I,
I( no. wl
If name
�(o- a�_ aoo-oo/.7a-s-�o/
Mprtgage / ContraG 6�de6tetlness unpaid az of Mortgaga I Conbap'uMebtedn¢s
MarU t. Wtm,nl yetv Eete W ePP���
9� � c
r e�acl share of interest? tt awnad vnN someone oNU Ihan spouse. [
GiRemit than ihat o1 appGCant u�tlilate below. la tl�e,prt
Name of mortgagee a mntract uller
Gn� �! c.
— ---- _- =
Add�ess of mortgagee a cantrad SeDer (numt __'_. ""__'—`—.-
Nama o( assi9nee w other owner or holtler of � Q
Dra��'Cr NO.....�"•.......
naaress
�t��
gPp11m(1( qVf1 PfOPCITy N 211`� ONCI
Y �� �m��
❑ Yes
Card NO�....1?�•c,,p,
� 10$, 000. � �� .9n
Drduction apprwed'm ihe amount of.
20 20 _ 20 n
n
Sig�ature ot Camqty Auditor
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I/ We certify under the penalry of perju at the above a re
owner / contract buyer ot the aforementioned properry on te a�
Sigrenue ( wneYS h� reme)
k � IN�..,�-
� FWI �esident aEdress W e t(num� �� � I�y��7 �d $� p�
S j 7V ci
Person auUro� by duty executed Pov.er of Attomey or by IC 61.1-12-0.7
AAdress of autlroraed per'..on (num6e�antl sbee4 �: �re, an0 ZIP code)
COUNTYAUDROR
mpaN as of Is the app'rcant Ne wle
legal w eQUiraHe ovnre/!
O ❑ Yes ❑ No
dicate with wtnm
�ertY in 9ue5UOn: Mmia�Y A55esv.-0
ProPertY Q Fvuivalh'.Assessed . . .
iid51116 �UCLOf1 b2Cf12QUC5:Cd OIl pf0�2lly
���a„� n Y� ❑ No
20 _ 20 _ 20 _ 20 _
County Date (rm'fh. daY Y�A
ig infwmation is we and mrrect arM that the applirant is a resident of Indiana aM
ation is filed.
Date (rtmfh, daY• Y��)
N 4 7 i> �
Date (monN, Eay,