HomeMy WebLinkAboutMortgage_Schenks (2)N" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
- = FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year
S� j State Form a3�oe (Ra i to-ot� _�
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� Presuibed by DeDaM�enl of Local Govemment Finance
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INSTRUCTIONS: File'IOlark
To be (led in person or by mail with the County Auditor of the county where the property is located. �� �b--�
Filing Dates: 1) Real PropeRy: During the 12 months belore May 11 of the year the deduction is to be ef/ec ive�1 on
2) Mo6ile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 31 0/ the year ��tle�iic7ioaug�� be eNective.
See reverse side for additional instiuctions and quali�cations.
Appiicant (ownerorcontract
Assessed value of real property as
March i, current year
If no, what is his / her exact
see restrictions on reverse side)
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Key number / legal description
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Record number
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MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, cunent year owne(? �%!es ❑ No
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If name on record is different than that of applicant, indicate below:
of mortgagee or contract seller
If owned with someone other than spouse, indicate with whom.
of mortgagee or contrad seller (number and street, city, state, ZIP
assignee or other owner or holder of mortgage
Address of assignee (num6erand street, city, state, ZlPcode)
Dces appticant own property in any other If yes, what county? What Taxing Distrid?
county in Indiana?
Deduction approved in the amount of:
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COUNTY AUDITOR
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1�iT8al� ,rl ,b
County Auditor
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Is the property in question:
❑ Mobite Home (IC 61.1-n
Has this dedudion been requested on
property for curtent yeaf? � Yes � No
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Date
/ We certify under the penalty of perjury lhat the above and foregoing information is true and corred and thal lhe applicants was / were
i residenl of Indiana and owner of the aforemenlioned property on March 1, 20
address
or by IC 6-1.1-12-.07
Address ofauthorized person
ofAtlorney