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HomeMy WebLinkAboutMortgage_Wright (3)a°�R�" t STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS C � Tov s ip Year ;+ °., : FOR DEDUCTION FROM ASSESSED VALUATION — \ �f, Slate Porm 477W (Ra / to-Ol) PreSCnUCW by Depanment of Local Govemment Finance � �. INSTRUCTIONS: �File �� To be filed in person or by mail with the County Auditor ol the county where the property is located. Filing Dates: 7) Real Propedy: Dunng the 72 months before May 71 of the year the deduction is to be e p���,17y pUDI'T�R 2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 0( the ye�educlion is to be elfective. See reverse side lor additional instructions and qualiTcations. Applicant (owner or contract 6uyer - see ���,�i, .� �. a,.�_ � Cev,fier 1 w � � Assessed value of real property as of March 1, current year no, what is his I her exact share of interest? on reverse side) Key number / legal � -/3-3a- Record numbe e Q�Z_Q�,1�� �� � IPagenumber �� Mortgage / Contract indebtedness unpaid as of Is the applicar March 1, wrrent year owner? �.�6/. ���� D �_--_ SD 2 � .�the� oie legal or equitat L�YYes ❑ No '� 168, oa0 _� -�— If owned with someone other than spouse, indicate with whom. If name on record is different than that of applicant, indicate 3me of mortgagee or conVact seller �1fi�� ra � c� � k �— jdress of m gagee or contrad seller (number and street, city, state, ZIP ,�.�,_ �._� v., a,,,.Rl,��,�„���i:ll,o ' Name o( assignee or owner or holder of of assignee (number and street, city, state, ZIP Is the pr ❑ Real 770.� D quesnon: ❑ Mobile Home (IC 61.1 ��-�Bl�l ag- �%o� Does applicant rnvn property in any other If yes, what county? I What Taxing District? I Has this deducifon been requestea or county in Indiana? property for current year?� Yes� N Deduction zo Signature in the amount of: 20 20 � � i COUNTY AUDITOR zo �09 � zc � � County Auditor zo 20 �I/ We certify under the penalty of perjury that the above and foregoing informalion is true and wrrect and ihat lhe applicanls was / were a resident of Indiana and owner o( the aforementioned property on March 1, 20 r Signatore (owners (ull name) Person auihorized by duly executed Power ot Attorney � /. l . //, - �'1 /_ >n.�,�,,Z� o� by ic s-�.i-iz-.o� _ — Full resideni address of applicant of authorized person