HomeMy WebLinkAboutMortgage_Cochran (2)STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS - -- --
FOR DEDUCTION FROM ASSESSED VALUATION �,Coun 7 G( /Tow�ri�iship�� Year
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INSTRUCTIONS: �-y�, File Mark
To be filed in person or by mail with the County Auditor of the county where the property is located. o�`6� '� �'`�
Filing Dates: 1) Real Property: During the 12 months be%re May 11 of [he year the deduciion is to�be e/�ectt�re,yTY AUDITOR
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year the deduction is to be effective.
See reverse side for additional instructions and qual�cations.
Appliwnt (own r or cont�act buyer- see tricti on reverse side)
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Taxing Dist d Key number / legal desuiption Record number O�
C. —/��� ( 1 % ��" //X'X-1�l�� Page number / � / �
�.u,r� �[J �.x_e.�o �
Assessed value of real property as of MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year �� �� owner? ❑ Yes ❑ No
If no, what is his / her exact share of interest? / If owned with someone other lhan spouse, indicate with whom.
�- /� � - cn- cm. �e� ��
If name on record is differenl ihan that of applicanl, indicate below: Is the property in question:
❑ Real Property � Mobile Home QC 61.1-�
�me of mortgagee or contrad seller .
Address of mortgagee or cont�aIX seller (number a d street, city, state, ZIP -
Name of assignee or other owner or holder of mortgage "
Address of assignee (nu `
Drawer NO.:b S� •�•� 9?'
Does applipnt own proF —� • hat Taxing Distrid? Has this dedudion been requested on
county in Indiana? � property for current year? � Yes ❑ No
CardNO . .....................
�DITOR
Dedudion approved in the amounf of:
20 � 20 �_ 20 �_ 20� 20 20 20
.p la �
1 I
Signature County Auditor Date
� We certify under lhe penalty of perjury that the above and foregoing information is true and correct and that the applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
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Full resident address of applicant Address of authorized person