HomeMy WebLinkAboutMortgage_Harvey`°�' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' c FOR DEDUCTION FROM ASSESSED VALUATION 3Count 7ownship Year
S �/ State Form� 70 P(R4 / 10.01) � p ��
�•�. p�
Prescribed De artmenl of Local Govemment Finance 1
AUG �s u 2002
INSTRUCTIONS: File Mark
To be filed in person or 6y mail with the County Auditor o( the county where the property is locate
Filing Dates: 1) Real Property: Dudng tbe 12 monfhs 6efore May 11 of the year the deduction is effe' '
2) Mobile Homes assessed underlC 6-1.1J: Behveen January 15 and March 31 06 fi���� �d,Giio�njJs��.� e effective.
See ieverse side (or a itional instructions and qualifica[ions.
— - Z C�i l G
Applicant (ownero�ontract buyer- see �estricbons on reverse side)
i/ /
/�1�
Taxing Dislrid Key number / legal des ' ion Record number Q�
l Q O 3- O( ��� � Page number ��� �
Assessed value of real property as of Mo\ge / Contract indebtedness-unpaid as of Is the applicant the sole legal or equitable
March 1, current year March i�current-yearf ownef? ❑ Yes ❑ No
D
Ii no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different ihan that ot applicant, indicate below: Is the property in question:
❑ Real PropeAy ❑ Mobile Home pC 61.1-�
�e of mortgagee or contrad seiler
Address ot mortgagee or wntracl seller (number and street, city, state, ZIP •
Name of assignee or other owner or holder of mortgage
Address of assignee (num6erand st�eet, city, state, ZIP code) -�i�7�---L '
Does applicant own property in any other If yes, what county? What Taxing Distric!? Has this dedudion been requested on
county in Indiana? property for current year? � YesO No
COUNTY AUDITOR
Deduction approved in the amount of:
zo Q zo 2o a s" zo b6 zo �� 20 �g 20 � q
9�-BoA-- I� � P P
Signature County Auditor Date
We certify under lhe penalty of perjury lhat the above and foregoing iniormation is true and corred and that the applicants was / were
, reside Indiana and owner of the aforementioned property on March 1, 20
Si n re (ow ers �ull n e) Person authorized by duty executed Power of Attomey
� or by IC 6-1.1-12-.07
F il r�idevnt2address of applipnt D� Address of authorized person
,�f