HomeMy WebLinkAboutMortgage_Virden/i�`� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ----�
I\ FOR DEDUCTION FROM ASSESSED VALUATION '}��u q Count � Township Year
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� PresQibed by Depanment of Lonl Govemment Finance �
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INSTRUCTIONS: �� File Mark
To be (iled in pe�son or by mail with the CountyAuditor of the county where the propeRy is located.a�
Filing Dates: 1) Real Property: During the 12 months before June 11 0/ the year lhe deducSon�is to�b��eKectiqe:DITOR
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and Marcbl�b�the'year the deductlon is to be effective.
See �everse side for additional instructions and qual�cations.
Applicant o br or coqtract buyer see restrictions on reverse side)
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Tauing istrid Key number / legal descripti n
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Assessed vatue of real property as
March 1, curcent year
what is his / her exact share of interesl?
Mortgage / Conirad ir
March 1, current year
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Record number
Page number T�� �
d
Is the applicant the sole legal or equilable
owneR ❑ Yes ❑ No
unpaid as of
If owned with someone other than spouse, indicate with whom.
If name on record is different than that ot applicant, indicate betow:
�;me of moAgagee or contraG seller �
W �%
Address of mortgagee or contrad seller (number and st2et, , state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street, city, sfate, ZIP
Does applicant own property in any other I If yes, what county?
county in Indiana?
Deduction approved in the amount of:
20 0 I 20 0�
P V
Signature
s the property in question:
❑ Real PropeAy ❑ Mobile Home QC E7.1-�
O _
Dra�ti�er NO ��?.- .�. ,2
f
Card NO . ..................... —
Taxing Distrid? Has this deduction been requested on
I property for wrrent year? � Yes 0 No
COUNTY AUDITOR
20�9 20 20
P
County Auditor
20
Date
20
We certiy under the penalty of peryury that the above and foregoing infortnation is true and corred and that the applicants was / were
resident of indiana and owner of the aforemenlioned property on March 1, 20
Person authorized by duly exewted Power of Atlomey
or by IC 6-1.1-12-.07
,� I fGll �esident address of applipnt n IAddress of authorized person