HomeMy WebLinkAboutMortgage_Strickland (8)'°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_ FOR DEDUCTION FROM ASSESSED VALUATION ./
. � State Fortn 93709 (R71 / 609) \r\0 [/
�• / PreuriOed Cy OeGa�M of Lxal Govemment Finance V
�w � �' � File Mark
INSTRUC110NS: �\ �
To be (led in person w by mai/ wifh the County Auditor or Counry Recorder of the counry where tf le pioperty is located. F� �� ��
fitirg Dates: 1) Real Property: Must file durirg the year fo� which the deductlon is mught.
2) Mo6de / ManuFaUUmd Homes rrot assessed as Real P �—�unry Auditor
mperfy.� Must h7e dunng t i M1velve (72J months
before Ma�ch 31 0( each yeur the deduction is sought ❑ Counry Recorder
See reverse side (or addrtional in�WCtion3.an� qualficatrons. �
AssesseE vWic cQ 2al p�opert�j at of
Me�d� t, arre�rt year
n m. what b his � her e�a slure a inrrmia
1 � 1^ IW I�.Y �
aesaiw:r '
o-�.�-4�ao-0�.733-00/_ � ,
le / Conbau IMebted�ress unpaid az W Mortgage I Contraa
. arreQt YPar_ � dace W ePP��
tt narne m remE's dmerem than that a( aPP��L "uMicate hebv`
Name W mortgagee a mnuxl seYer l
C
Pddress oi �mtga9� or contraa seDer (nunbr,i and sfreeG
Name ot a4ignee w oihrl wmer or hdder of rt�ortgage
Atlaratis ot atig�fee (mmIDer aid sheet �: stete. an0 LI
Does epplimrt own property in any other It y�
m,fuy m ��eianaa
❑ Yes ❑ No
D2dULbM 2CG� YI iA8 dRqUN OF.
�
20 2o Y� A n. 20
unGaitl as d I Is itre ePP�i Ne sde
legal or equBade ow+�M
❑ Yes ❑ No
rc owne0 wiN saneo�re aher Ihan spouse. 4dimte wiM Mwm
i`r
ao�� ......
llra,�•cr �o..........
: � - � . . . :.. 5�� �
Cai�d NO: .......
_'.... � i nuul l VK
20 _ � 20 _
IS NC W�De�' 111 G�16f10f1: MfW3MA55lSSI.E
❑ Reai PmPeKY 0 !+!m�!a�Y �
3s�N�'a�ded� Deen re7uested m PtopertY
❑ Yes ❑ No
20 — � 20
AWrtw (/^ 1 Caun n,^ �I. Date (rtunN. tlaYf Y�� �7 o
ry,l� �.X_� ry IW.A/V\ 1 I�I CI_ 7—_
I/ We ce' urWer e penalty of perju�1�at the above and foregoing intortnalion is We and correct arW that Me applipnt is a resident of IrWiana aM
owner I mntract buyer of the atoremen0�ed property wi date applicatlon is filed.
i��(y� ) Date (manfh. aaY.Yge�
i revCe � aEdrnss of appfaanl number and sbee4 �Y, ��e, ard LP coEe
53oa s. da � E, aaki�d C,�,� �,� u�GG�'
rson autho�aeC by dWy exeaitetl Power of Auorney or by IC 61.7-12-0.7 Date (rton(h. dsY. Yea�)
AddR55 Of 2uthps¢E p¢RM (numbe/ aIM sbee; fl(y, Sfate, 2nC ZIP mtla) .