HomeMy WebLinkAboutMortgage_BowdenSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
++ �w� ! SUte Farm 43709 (R5l 4-03) ���(((
P25aibed by DepaRment ot Loral Govemment Finance �(� �
� �� 7
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INSTRUCTIONS: QPR $il� N�4
To be filed in person or by mail with the County Auditor of the county where the property is located. �
Filing Dates: 1J Real Property: During the 12 months 6efore May 11 of the year tAe deduction is to b�i effective.
2) Mobile Homes assessed under IC 6-1.1-7: Belween January 15 and March 2 0/ the �eakthe ded�tioa�s�to be���e-cR�e ��pve.
See reverse side for additional instructions and qual�cations. �� ��°SO,ti GQUM17'Y q�ipiTC ;;
Applicant (owne� or contract buyer - see
Taxing Distrid
Assessed value of real property as of
March 1, current year
no, what is his / her exact share of interest?
If name on record is
Address of
on 2verse side)
Key number / legal description Record number
O` / Page number
� �lo'�
MoAgage / Contrad indebtedness unpaid as of Is the appli�
March 1, current year owneR
that of appiicant, indicate below:
or contract seller
� legal or equitable
❑ No
�ao� � �
If owned with someone other than spouse, indicate with whom.
or contrad seller (number and stieet, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, sfate, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
Deduction approved in lhe amount of:
20 20 �
Signature
COUNTY/
20 �� 20 �_
A �
County Auditor
❑ Mobile Home QC G1.1-�
n
Dr.awer NO ...................
Card NO. ..i� 3^/G�� ��� �e uested on
9
.•.•.....•... r?�Yes❑No
20 � 20
�
20
/ We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resideni of Indiana and owner of the aforementioned property on March 1, 20
Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
of authorized person