HomeMy WebLinkAboutMortgage_Russell^' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
_, FOR DEDUCTION FROM ASSESSED VALUATiON
� sa�e r-o� aa�os �aii i soe� �
,,.,� Pmsfiibed ty Departrt�aM of Locai Goremmerrt Firence
Fi rk
irurnucnoNS: F� � �:
To be filed in permn w by mail xitA the CountyAuditor w Counry Recorder o/ Ne pounry where the property is bcated.
Fdirg Da[es: 1) Real Property: Mus! file durirg the year fw which tha deduclion is soughG N O �� 10 Auditor
2J MobAe / ManWectuled Homes not assessed as Real Prtiperty Must Ae durvig the tweA�e (72J months ❑
before Maich 31 of each year Me deducbon is �hG �^ry R��
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See reverse side lor addiGOnal inshuctions and 9velifications. �°J ' (�'
nppG��y(ow,rero�mnoa(rwyer-seeresh:-�sonmrerse ) _ _ CiIBRf)N COUNTY AIU�iITQR
' Distrv� Key rwmber / legal dewiption
-a3 -olo-�oo-000-
Assrssed �alue d real P�D�Y as d AbRaape / Cantraa irdrbteCnass unPaiO as o(
M�d� t. amm y�r Mard� i. airerrt yem
0 ov
ir �o. �� � na i n� e�a sn� or mi�+a rc o�e
If narne on remrtl is Eifterent Man ihat
a wnttact
(mmber erd sbeet �Y. state.
Nama of azsignee a ahej wmer w halder of mort9a9e
MCrPSS ol asse,�ne� number end sheet mY, sm�. and LP code)
�T � �a-`f-/O �f1 �
oaes epqimm ow,� v�a�r � a�y amc rc yes. what muntyl vmat rad�y r
couHy m Inaeria7 � Yes ❑ No
COUNTYAUOROR
Deduc6on approved 4� tlre amaint at
2p _ 20 _ 20 _ 20 _
. I I We cerGfy unEeffhe penatty M
rnmer / contrad buyer of Ne afon
� Sgradre
�FW ' en a t(rwmDe
' l� u 5
aereo� aw,ar¢ea ey amr �,tea Pwv
PddressofauC�MUdpenon (numbera
Reoortf mimOU Page
- oo D D � � �
� vWeebteaness unpal0 as d � or�� wme/?
❑ Yes ❑ No
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�s a�aero �^ awstim: a,nu
Real Roperty ❑ nrmual
Alodle
llraiti�er i�'p,..., �p/ v
Card t�,-p y8// .. ..
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Date (rnoNh.
Ne above aM foregoing informalion is true and cortect and Ihat the applirant is a resideM of Irdiana aM
P�PertY on date aDdiption is fJed.
-/ Data (rtanCt daY.Y��)
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