HomeMy WebLinkAboutMortgage_Grinstead"`� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
__ .= FOR DEDUCTION FROM ASSESSED VALUATION
� s� �Rn a3�o9 (a�i i aas�
�„» � aresa;bea ey oepartmem a� Lo�� cwemmem Fl�snce �
INSTRUCTIONS: �
7o be filed in person w 6y mail wiN Ne CountyAUditor or Counry Recade� o� the oounty wl�ere the properry is located. D
Fiiing Dates: 7) Real Properry: Mus! fife durirg the year (o� whirh fhe deduction is soughG
2J Mo6�7e /ManufaUured Hwnes rrot assessed as Real Properiy: Must file dunng the twelve (12J monNs
6efore Maich 31 of each year Ne deducbon is sought.
See reversa sida for additional instructbns arM qualifications.
Inypfrant(owrre�aroww�al.Quyer�seerestrirlionsmre e) A ' . n GIBSON
_ ,�._, .,_ <<�� �_
1, wreN year
�i M. W�12� 6�16 � �12f P.I3li
tt name m remd is Qf.femn[ Man fhat of aPP��L trMimte 6ebw.
Name of mortgagee or mntraa seller
strceL �Y.
LP mde)
Remid num
�_�u1-c� s
unpaid as of Mwtgaqe I Contraa'udebtedness unpaiA as of
date a( eppfi�tion
Does applit�ant ovm property in any aher 11
munrymind"ana? ❑ Yes DI�aliVer N�........
o���,���,e���er Card NO. ...°�9��.... —
p_ p_ c�,(� �1ap,cno.`r'/ �-
��� � �ry���
��H
Sp0�52.
County Auditnr
Gounry Remrder
Yes LI No
Is Ihe D�PPnY in questim: MnuaDY Asussed
❑ Real Property Q Mmually Assessed
Nis tletluaion Daen requested m p'operty
u�rent W,a/? r-i .. r--i
�
�Y,,��
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I/ We certHy urWer the penalry of perjury that the above arW (oregoing infortnalion is W e and correct arW that ihe applirant is a resitlent of Indiana arM
owner! contracl buyer ot ihe atoreme'rtioned PmPertY on d�}e,�PGiiptlon is filed.
rtaWre fuffierrrel _ � — Date (rtoNh. daY. P�h
�a�e (rmRh. d3Y. Y��)
AACrass of autha'¢ctl pelsm (numDer eM sbne; �if}; state, aM ZIP mtle)