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HomeMy WebLinkAboutMortgage_McCrary"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Y y :._— = FOR DEDUCTION FROM ASSESSED VALUATION • State Fwm 93709 (R71 / 609) �� Presaibed by Departmertl af Loml Govemment Finance File INSTRUCTIONS: To 6e lled in person w by mail with Ne CounfyAUdilor o� Counry Recorder o/ fhe county whe2 fhe property is focated. F� �� ��: Filing Dates: 7) Real Property: Must file during fhe year for which the deduction is sought. � III��� 2J MobAe / Manufactured Homes rat assessed as Real Property. Must fiie dunng tAe fweHe (12J months r\ before March 37 of each year the deduction is sought ��^�Y � See 2verse sida /or additmnal insfrucGons and qualfications. ' Appfxanlsp`riar oroonvaft 6uyner- see r�MCBO�xt o� reverse sitle) � C n � Ta/b�/p Distrct Key�wmCer/legal0esaiptionp. l" ' 'Z O'��0 ' ��( Assesse0 rdh�e d rnal property a d MoRUage / Contraa "v�tlebtetlness unpaid az of Ma�di 1, t�ie�ent yar Mara� 1, wrtem year I 0 I( rw, wha� is his I her exact share Of interesi? If owrn It rame on recwd is dMerent ihan Ihat al apP��L �d�mte below. IJame al rt�ortgagee or Address stae, ownerar (num6er aM streef, dry, slate, and ZIP code) I � ' sorneorie Oces e�irant own poperty in any oNer I I( yes, what wunt�? I VJhal Ta�drg DistriC? munry m IrWiana? ❑ Yes ❑ No Recwtl uWebtedness unpzid as d is ihe ap�t Me sNe legal w eQUilable owm.Y? ❑ Yes ❑ No han spouse. iMinte wiih whom Is Cie P�P�Y in Cuestion: MnuaM Pssesse0 �I Roperty Q Mnually Pssessed Mobile Fiane (IC 61. Has U�is deduGion Deen requesle0 rn PropenY for curtent yeaY.� r-� ._ r� COUNTYAUDROR DeGUCOm appfo.�ed'm ihe amouN of. � 20 20 _ 20 _ 20 20 20 _ � Sig�awre o/ Co�mN Audiior Counry Date (imnlh, daY• Y�� I/ We cert'rfy under the penalty of perjury that the ahove arW foregoing infortnation is true and cortect arW that Ne applipnt is a resident of IrWiana antl ovmer I mntract buyer of the aforemeMioned property on date applirabon is filed. (owreh hAname) Date (nmN. daY. Y�� �, m -is-►► Fuil revtlent address of appfrcant (numDer and sbeef, tity, state, and ZIP aotle) a l� s � s E A K�a o r�- �( � ��G o Person auNO'rzetl by dWy ezeaitetl Power of Attomey or try IC 61.1-12-0.7 Date (rtronN, tlay, yea� Adtlress o( auNa'ved persai (num6er aM stree; fi(y, sb(e, aM LP mde) .