HomeMy WebLinkAboutMortgage_MontgomerySTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS \
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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� P25cribed by Departmerit of Laal Gtivemment Finance ,�y' -r � �r-� 1� �
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To be filed in person or by mail with the County Auditor of the county where the property is located. ,
Filing Dates: 1) Real PropeRy: During (he 12 months before May 11 of fhe year the deduction is to 6e eHective. � • f� ��
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the)year fhe,deduction,'is to be'eHective.
See reverse side for addifional instructions and qualifications. ��GIBSO�+ C�O'J'•' '�+���'�� �'
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Assessed value of real property as of Mo gage / Conlrad ii
March 1, current year March 1, current year
number
unpaid as of I Is the a
ownef?
��_�a�
�al or equitable
No
If no, what is his / her exad share of interest? If owned with someone other than spouse, indicate with whom.
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If name on record is different ihan that of applicanl, indicate below: Is the property in question:
peAy ❑ Mobile Hane (IC 6�1.1-�
�me of mortgagee or contrad seller
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Address of mortgagee or contract seller (number and street, city, state, Z!^ —�-�
Name of assignee or other owner or holder of mortgage
of assignee (number and st2et, city, state, ZIP code)
Drawer NO ...................
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Card NO: ....
Does appliwnt own property in any other If yes, what county? Wt „_._,,,..,.
county in Indiana?
u (v� (� 3 , -3 _ �. COUNTY AUDITOR � ,
Deduction approved in the amount of:
20
Signature
20
20 V•1 20_()� 20
� �
County Auditor
„d� mis aeauaion oeen requested on
property for current year? � Yes � No
�
20
Date
20
certify under the penalty of perjury lhat the above and foregoing infortnation is true and corcec[ and lhat ihe applicants was / were
lent of Indiana and owner of the aforementioned property on March 1, 20
ire (owners (ull name) Person authorized by duly exewted Power of Attomey
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Full residLsnt address of applicant 7 O IAddress of authorized person