HomeMy WebLinkAboutMortgage_Perry���STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun /Township Year
�J • Sute Fwm 43709 (R6 / SO6)
Presaibed by Department of Lotal Govemment Finance
�
INSTRUCTIONS: � �
To 6e filed in person or by mail with the County Audilor of the county where the property is loc
Filing Dates: 1) Real Property: Dunng the 12 months before ,lune 11 of the year the deduction ' o b . .
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year thef�e ction is to be effective.
See reverse side fo� additional instructions and qualifications. N0V V�2��6
Taxing
Assessed value of real property as of
March 1, current year
no, what is his / her exad share of interest?
on record is different
of mortgagee or contrad
reverse
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Dp3'-oa99s���
GIBSON
number
number
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or e
March 1, current year ownef? � Yes ❑ No
�S'o�c
If owned with someone other than spouse, indicate with whom.
indicate below:
of mortgagee or contract seller (number and street, aty, state, ZIP
assignee or other owner or holder of mortgage
of assignee (numberand street, city,
Does appliwnl own property in any other � If ye_:
CN�nfi..:.._i_�:__"... _ —_ _ .
r
- Dra�ver NO. Q.�.-. ��.y.�
�s
� Card ti0 . .....................
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county? � What Taxing Dislnd?
COUNTY AUDITOR
zo �`L zo 20
P
County AudRor
Is the properiy in question:
O Real Property ❑ Mod'le Hortie (IC 61.
Has this dedudion been requested on
property for current year? � Yes ❑ No
zo
Date
zo
We certify under lhe penalry of perjury lhat lhe above and foregoing infortnalion is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
full name)
Person authorized by duly executed Power of Atlomey
or by IC 6-1.1-12-.07
applicant �Address of authorized person