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HomeMy WebLinkAboutMortgage_CreedonE� °'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year ..: r FOR DEDUCTION FROM ASSESSED VALUATION State Fam 43709 (R8 / 2-07) �O 1 Presaibed by Department d Local Govemment Firence J ��N File Mark INSTRUCTIONS: To be filed in person or by mad wifh the CountyAuditor of the couirty whe2 Ure p/opeity is bcated. ���� � Fding Dates: 1 J Real Property: Dunng the 12 monfhs befae June if d fhe year ffre deducfion is to 6e etfective. 2) Mobile Homes assessed under IC 6-i. f-7: Behveen January 15 and March 2 ot the year tfre ded ti i o b el/ t e. See reverse side tor additional inshuctions and qualificafions. . Applicant (ownerormnLad bvyej.�se� re4iiclionypn reverse sde) �'1 n Q 2 L Tauig Dislrid Key rwmba / I �b - l -19 -� AaesseA value ot real papaty as d Maich 1, aarent yrar '���J name on record is ddtarerrt Nan lhat of applipnl, irWiple belo.v: ame of mortgagee or carN-act seller Address of mortgagee or mnlracl shee(. dty. sTle. arM ZIP Name of assi9rree w dhei owner w holder of mortgage Address oi asv9�e (rpttMer ar�d shae; dty. slate. ard ZlP mde) " Does applicanl own property in any oNer counry in Indiana7 ❑Yes ❑ No Dedtxtion approved in Ihe amounl of: 20 0 zo � SynaWre of CounryAUtlGOr of March 1, � If yes. whal oounry7 I Wha1 Ta�dng Distrid7 C ��c.0o�, C'KAD A SaO-Oy— �NT�'G�'A ,�.3/ oou � — �OdB-33 / � — i �«nn, ❑Yes ❑ No spouse. �caie with whom. Is �he property in 9�tim: ❑ Real ProceAV ❑ Mobile Home (IC 6-1. Has this tli For currenl zo requesled on poperty ❑Yes ❑ No Dafe (mon/h, day, yea� zo I/ W oertify under the penalry of perjury that ihe above and foregoing infortnation is true and correc[ and tlut ttie applicanls was I were a residenl of 1 ana and owner oi the aforementioned property on March 7, 20 �a4uy,(pwnerslWlnaare) /� �� � Oate (manlh, day, yea� atldress sGeef. city. state, and Po.ver of Altarrey or by IC of authw¢ed pe�sm (�umber arM streeC dty. s(afe, aiM LP mAe) u �