HomeMy WebLinkAboutMortgage_Phillips (2)'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
s�ate F«m e37os (RS � z-07)
j Presrnbed by Departmenl W Local Govemment Finance
INSTRUCTIONS �
To be (led in person or 6y mad wrth the County Auditor o/ the county where fhe property is bcated.
Fding Dates: i) Real Property: Dudng the 12 months be%re June 17 o7the year the deduc6on is to be effective. '�uN 1 2 Z��B
2J Mo6ile Hanes assessed under IC 61.7-7: Behveen January 15 and March 2 of the year the deducGon is fo be eflec6ve.
Sae reverse side fw additional insWcLons and qualifications. `�� .
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Apq nt( rorm wye�-se «u��sversesde . �BSONCOUNTYqUDITOR
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T' 'sVid Key nu ber / legal desai ' n - Record number Page mimber
- �- - �/b- . O - � 00 O�
qss�d ralue M real popaty as aF Marfh 1, aarent y�r Matgege � CunVad iMebledness unpaid as of March 1, Is Ihe appGfanl Ihe sde legal a equitahle wmell
airtent year �7
" /7( iifY1 �Yes ❑ No
/ her rxaa share ai'viteresl?
If rame m recwd is d"Aierent than
Name o( rtortga9ee or cmlraG seller
/� p aQ2c.n-rt
Adtlress of mortgagee or mnlrad seller (number aiM sfreet. oty, slate, and
Name of assi9nea a oV�er awner w hdder of mMgaga
Address of asvgnee (nwnberarMs6eet city, sfafe, ano
Does applicanl wm property in any other
counry in Intliana?
❑ Yes ❑ No
Deduction apprwed in ihe amount of:
�� � aP 1
SignaWra of CounryAud�tnr
If owned wi�h mrt�eone olher ihan spouse.
If yes, what cwnry7 w
COUNTY AL
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, �
I/ We certity under the penalry of perjury ihat fhe above and fwegoing infomia
Indiana and ovmer of the afwementioned propeAy on March 1, 2b _ �
af applicanl (num6er antl streetJcdy. sfafe.
Pason au11a�¢ed by duty ex�
Pddress of aulhw¢ed pasan
a by IC 61.1-12-.07
ard slieef. M}; slate. arM
Is ihe praperty in questim:
❑ Real Property ❑ Mobile Home QC 61.1-7)
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