HomeMy WebLinkAboutMortgage_Norrick�V'° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
`i�, i FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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P2scn0ed 6y Department of Lorat Govemment Financa �
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INSTRUCTIONS: `�tr � b F{IeWi"ark
To be filed in person or by mail with the County Audiror o/ the county whe�e the property is located.
Filing Dates: 1) Real Property: During the 12 months betore May 11 of the year fhe deduction is,fo be eRective. � I��7
2J Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 0/ fhe�year th deduction is to�be effective.
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See �everse side for additional ins[ructions and qualifications.
Applicant
i axing
contract bu�er - see
Assessed value ofrealproperty
March 1, wrrent year
no, what is his / her exact share of interest?
on
0
Key number / legal description
�/� - �%%�-�
Mortgage / Contract indebtedness unpaid as
March 1, current year
Record number
O f3
Page number ' �� �
F Is the applicant the sole legal or equitable
owner? �i1Nes ❑ No
T
If owned with someone other than spouse, indicate with whom.
If name on record is different than thaf of appliwnt, indicate below:
�ame of mortgagee or contract seller��� �
A�ddress of mortgagee or contrad seller (number and st2�ity, state, ZIP
Name of assignee or other owner or holder of mortgage
assignee (numberand street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing C
county in Indiana?
approved in the amount of:
20 Q+� 20
�'TRBO A
Signature
COUNTY AUDITOR
20 � 20 �Z 20
�
County Auditor
property in question:
�al Property ❑ Mobile Home (IC 61.1-n
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03-►�,�3
20 � 20
i
Date
lon
� No
I/ We certify under ihe penalty of perjury that the above and toregoing information is true and correct and that the applicants was / were
,resident of Indiana and owner of the aforementioned propeAy on March 1, 20
(owners full
resident address
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
of authorized person
Y �60