HomeMy WebLinkAboutMortgage_Gries°'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
s�a Fmn a3�oe cae � zo»
�� � presoibed by Department of Local Govemmenl Firance T
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�NSiRUCnONS: File�a
To be filed in person w by ma� wilh the CourttyAud'dor o/ the courrty where Bre pioperfy is bcated.
Fding Dates: 1) Real Property: During the 12 monMs be/ae June 11 W the }rea� fhe deduction is to be elfective. � r K 2� 2009
2) Mobile Hames assessed wMer IC 6-7. 7-7: Behwen January 15 end March 2 0/ fhe year Mre deductim is to 6e eAecLve.
Sae reverse side lor additional insWctions aied qualifitations.
rg isna
ae-
rdue of real P�P�Y as d'�
If +hat is his / har erxl share of
If name m record is ditFereM �han iti
stricfjs�m revarse Side) , -
� 61B6GN COUNTY AUDII
rnanber negal desaiptbn Recma Page numter
3a - o -oo�. �g� -oa y ,
1, a+renl ya3r Mortpage I CoMract intlebledness unpaid as MM11����y.j Is Ihe app6fanl �he sde legal a equitahle omieR
aiRenl y Z�j '�
p�� ❑ves ❑No
sl9 If wme0 with sortieme dher Ilw� spouse. trMicate wilh whom.
nddrass of mongagea or mn4aa seller (rwmeer ar�a
Nartre of assignee ar olhet owner w hdder of matga
Address of assignee (rxm6er eM sUeet, oty, state. a
ooes apprwsM or„ propeiry in ary mn«
coumy in Indiana7
❑Yes ❑ No
Deduction apptoved in �he amount of:
0
Signature af
ara
ZI p �� �� �
��OW�:l�W�L �li
� �:
�', Drawer NO..��.�........
Card NO. ... �. J.9.%.........
��oi,a�.�
2p — I 20 — I 20
Courrty
i
Is ihe popeM1y in questim:
❑ Real Prtmerty ❑ MoMle Hare pC 61.
r�s u�is am�,e� nean re�u�ea o� a�a�r
fd artenl yeaR
❑Yes ❑No
���
Date (rronth, daY• Y�/)
20
I/ We certify under the penalty of perjury tliat tlie above and foregoing infortnatiwi is true and mrred and ihat fhe appfinnts was / we2 a resident of
Indiana and owner of the atwementirned property on March 1, 20
e(owne/s hdl nam�) _�i % . Dale (monN, daY Y�A
dy. sfate. aM ZIP oode)
by duy erzeaned Power
Adtlress of aulhor¢ed persan (number arM sbael. r4}: sfafe, aM LP mde)