HomeMy WebLinkAboutMortgage_Lyon.� °� STATEMENT OF MORTGAGE OR CONTRACT INDI
FOR DEDUCTION FROM ASSESSED VALUATION
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�' � Rasmbed M Depahrtrent or Wcal co�emma,� Frence
NM
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�NSrRUCnoNS:
To be filed in person or by mad with the CourttyAuditor W the courrty where the property is bcated.
Fd'ng Dates: 1J Real Proper(y Dunng the 12 months belore June 77 W the year the deduc6on is to be elfective. rQ
2) Mobi7e Hames assessed under IC 6-7.1-7: Behveen January 75 and Marcli 2 of the year the deduc��51o_be�e.
See revarse side /ar addiliortal insWctions and qualificafions. ��� COUNTY qUDITOR
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popaly as af Marrh 1, ae,ent ymr Abrtpage I CanUad indeWedness unpaid as o( March 1,
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If ro, tifat is his / he` ezacl share d'viteresl?
If reme m�ecard is diRareN Uan Ihal of eppl
Name
of rtqAgagee a mnlraG seller (n,miber and sVeeC dty.
af a5sgnee or aUrer oaner a hdder of maAga9e
Address of assignee (rxaMer aiM sGeeC �A: stafe. antl
ard LPcaOe)
Does applicar4 am PropertY in am olher It yes. wnat wunry'!
county ci Indana?
❑ Yes ❑ No
Deduction appiaved in ihe amount of:
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SignaWre of Coun�y Autlitor
0
COUNTV
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mrtreone olher Uwn spouse,
wnat ia�ang u�s�n+•
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R D L I P� /
��,�,���a���a�� �
❑Yes ❑ No
Micate wi�h whom.
Is Ihe property in ques�m:
❑ Real PiooeM ❑ Mobile Hane
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�Yes ❑No
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oate (manm, aar. r�A
i/ We certify under the penaity of perjury tliat the above and foregoing infwrt�ation is true and mrrect and that tlie applinnts was / were a resident of
F�a and owner of C�e afwementioned property on March 1, 20
(owne/s MI name) , Dale (mmfh. daY• Y��)
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Fy 2sidenl address of applicard r entl s6eeG cdy. stafe. and LP mAe)
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Person aulha¢ed by duy exeated Pwrer of Aporney d by IC 6-1.1-12-.07 � Dale (monlh, day, yea�
pefson (numberaMstreeGrAy.slata.andLPcotle)