HomeMy WebLinkAboutMortgage_MacMunn° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS oun T s i vear
_ FOR DEDUCTION FROM ASSESSED VALUATION
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INSTRUCiIONS: File MayAc�
To be filed in persan w 6y maH witlr Ure CourtlyAuditn d fhe covnty whera fhe poperty is located. �%% �/y-ey
Wmg Dales: 1) Real Ptoperty: Must Poe d�uirrg fhe yee� lor whk� the deducFion is snught. p'
2) Mobile/ManulaGured Homes not assessed as Real Properly: Musf file dunry tlie hreNe (12) rt��Q���Aqfb[k�C�ar
the deduclion is sought.
See reverse sbe (cr adddional insirudions and 4ualrfications
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Y ro, what 6 his / �a wotl shara d i`veresY!
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Name d assigfree or oiher owner a hotler d mwiBa6a
Addrass d�ignae (iwrtbor and sbeef. WY• ffib. aM Z
Ooas a7P��^� own VoPaM in arry dher
cau�ry in IndFa�9 � Yes �
DeAuction a00roved in iha amou�n of:
20�q_ 20_
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I 1 We certi(y unda the�ty of perj�ry Nat
owner / wniract buyer f ihe aforementbnetl
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❑ Yes ❑ No
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IC 61.
foregoing trifwmation is We arM carred and Ihat the applirant is a res0ent of Intliara arb
ta applitation is filed.
� Full residenl adtlress of applifant (mm�6erand sbeof. cily, sfalo. and LP
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Person aWharzeE W dulv erealed Pwer d Alfomev m W IC G1.1-12�
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