HomeMy WebLinkAboutMortgage_Bryson°� ��� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
(°i � A�
's'�" FOR DEDUCTION FROM ASSESSED VALUATION C n T 'p Year
� ,�JJ SUte Fortn G3709 (R6 / SO6) . . . ' . .
Presrnbed by Department of Local Govemmenl Finance
INSTRUCTIONS: - `�y� File Maric
To be filed in pe�son or by mail wrth the County Auditor of the county where the p�operty is located. v'(� .��
Filing Dates: 1) Real Property: Dunng the 12�months be/ora �uune 11 of the year the deduction is to 6��Fj'��p �NTY.
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 of the year the deduction ��i��fective.
See �everse side /o� addifional instructions and qualifications.
(owner or contract
Taxing
Q Q�,/<�
Assessed value of real
March 1, current year
see restrictions on ieve se side) �
/�-a�ha.�Ca%
° Key number / legal description
- ' � -/y-1 8 � /o� _ DDD,
� 737-00
as of
Ii no, what is his / her exad share of
MoRgage / Contrad inde
March 1, current year
�7� �QV'.
If a
If name on record is difterent than that ot applicant, indicate
mortgagee or contrad seller
mortgagee or conVact selier (number arid street, city, state, ZIP
Name of assignee or
Addressi
owner or noiaer ot mongage
�num�er ana street, aty, state, ZIP code)
Record number � � 0 �
Page number /� � /
.7 (p
as of Is the applipnt the sole legal or equitable
owneR ❑ Yes ❑ No
with someone other than spouse, indicate with whom.
.07-7��5
Is the property in question:
� Real Property ❑ Moble Home QC 61.
Does appliwnt own property in any other I If yes, what counry? What Ta�cing District?
county in Indiana?
Deduction
20
Signature
in the amount of:
20 �� 20
R
COUNTY AUDITOR
20
County Auditor
�
Dra�r�er 1�'O.. .�.�„?%... ' _
Card NO. ....J.r..,�.,�
.� I TI�bcO ......
20
Date
20
We certiy under the penalty of peryury that the above and foregoing information is lrue and corred and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
���n r(owners (ul na ) / K�r Person authorized by duly execuled Power of Attomey
N D. D, � �%f I/1, ./J� o� bY �� 6-,.,-,2-.��
Fuil res ent address
G
of authorized person