HomeMy WebLinkAboutMortgage_Doerner'� { STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
sale Form ea7os (Ra r z-07)
�' �� Presmbed by DepaNnent of Local Govemmerrt Firance
ile
INSTRUCTIONS:
To be filed in person or by mad with the CourrtyAUditor of the county wheie the pioperty is bcated.
Fd'aig Dates: i) Reai Property: Dunng the 12 rtronfhs be/we June 11 of fhe year the deduction is to be e//ective. F EB j 3 %� O9
2) Mobile Homes assessed under IC 6-1 _ t-7: BeMreen January 15 and March 2 0/ the year fhe deducLon is to be e9€clive.
See reverse side for additiorral ins6uctions a� qualifications. �
`�i7,,,_ �,�^"
Applicant (amerkx had qyyqf} see re rse sde) �. _ _�� I
�f O�io - I �f—
Asessed ralue of 2al prop of Marrh 1, aa`errt ymr Mort�
airre
If at is his / her exaa share af irrteresl?
If name on recorU is dAterenl ihan ihal oF applicaM, indiq�e belov�
� Name of mortgagee or cmlracl
�i
iMebledness unpaid as of Alarch
mortgagee a oontrad seller (num6u and streeG dty, stafe, arn0 LP oode)
assig�e or aU�er owner a holdrl of morigage
� Address of asv9�e (rucnbu arM sLeet. �'. Aate. and
someone
Does appliraN own popeRy in any olher If yes, what caunh? Wha1 Ta�mig Districl7
oounly in InGia�?
❑Yes � No
� Deduction �p�oved in Ue amaunt of:
`�
I/ We certif� under fh
Indiana and owner of
2o I 20
Person auUv¢etl by duN ��+��
of
❑Yes � No
spause, indicate wilh whom.
�s the propeAy in quesum:
❑ R�1 Procertv ❑ Mobile Hwne (IC 61.
Db��A�� �'�E�� �
!�'��6 A-� T
Oq � ��3
�
uesled on property
❑Yes ❑ No
20
hat Me above and fc __..., �ue and corzed and fhat the applicants was / were a resident of
property on March 1, ni
1 Dale (rtnnfh. daY Y��1
aM
pawi (number aM sGee; aty, state. aM ZIP wde)