HomeMy WebLinkAboutMortgage_Edwards (3)� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
__ . FOR DEDUCTION FROM ASSESSED VALUATION
sraca F«m a3�os cR„ � s-as>
,,�,� / P�esvibed by DePa�� ot la�ai Gwemment Firarce �
File Mark
INSTRUCTIONS: A P R 3 ���:
b 6e fJed in person or by mail wifh the CounryAuditor or Counry RecoAer of the county wAere the property is located.
Fifing Dates: 7J Real Proparty Must fJe durirg the year /or which Ne deduction is soughL County Auditw
2) Mobde / Manufadured Homes irot assessed as Real Property Must file during the hveNe (72) mo�a�
before March 31 oleacA year the deduclion is sought. Counry Recorder
Sea�everseside(oraddilionalinsLuctlonsandqualifications. C�IBSON COUN
IMO�P}(owrerwconhaoDuyer-seemsficlionsmreverseside) /1 � � .
OisfiC �
I vahc aF r� papeny es d
aneN year
mhrll kgat dew�lmn
-/3-�3-/�O -oo/. 3�3- o0
Mortpage / ContraU iMebtedness unpaid as of Mongape I Contrar2 i
Mard� 1, wrtmt year Eate of a0p�im
7�n DOQ
Ii m, what ts h'a / her exad shara ot inteJest?
H nama m n.md is 6fterent than that ot appOran;
Name W rtnrtgagee a rnnVact se4er n
/ �
l_ ��
AGd�¢ss d rt�orcgaga ar mntrad se�er (nun6er e�
Name M assignee or oNer owner rn holAer M mort(
aee�s o���a �numae.a�e�c �: usre.
mes epprcam ow� aopeny � e�y omn
counry u� Ind"ana4 � Yes
❑ No
Deduc6on apav.�ed'v� tlre amount oE
6�Eicate Delmw
_ p�, - �
cdy, sfafe, ard LP code)
COUNTI
20 _ 20 _ 20 _ 20 _
�nature W Camb Mditor
I/ We cer4fy under ihe penatty perjury that Ne a e arW foregoing infwr
ovmer I cantraci buyer of the mentlmed p on date appliralion is
slate, and LP mde)
�gga s q5o E �
Pelsan autfrorizeC by EWy executed
persqn (num6er eM 5freat C�y. sb(e. e/M LP code)
RemN numbr+ I Paye wmber
�itahle avmefl
Yes ❑ No
Is Me P�GertY in OuesDm: MmiaM Pssessed
� RE21 Prt]PeKY ❑ %vci�a�y Pss�sed
Abbile Fionte (IC 61.
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