HomeMy WebLinkAboutMortgage_Harper°'^• STAIEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ship ear
_ k FOR DEDUCTION FROM ASSESSED VALUATION
. s�ie Form aa�oe (rte � zo»
S,.» ���� ��anme�� � ��� �,��� F� 0 CT 2 4 2 08
File MaAc
INSTRUCTIONS: �-y� ��
To be trled in person or by mad with the CourttyAudrtor W the courtty wheie the pmpe/ty is bcated. p'� �
Fding Dates: 1) Real Proper(y: Dunng the f2 months before June 17 W the year the deduction is to be elfective. OUNTY AUDITOR
2) Mobiie Homes assessed under IC 61.1-7: Behveen January 15 and Marclr 2 of Me year the deduc6on is to0i0��.
See 2verse side for additional instructiqns eM qua6fications. .
ormnhadbuyer-s/je s6r/c'��ps mreverse
%/l O� / IaTlLlJ�d1.
1. aarml y�r
of iMerest?
If rome m recwd is dAleraq than that of epplican4 ��irate
Name of rtqtigagee or mNaU
crnaaa se�ler
a dher wvrie+ w halder of mortgage
Address of asv9ree (ixmibei aiM streel, city, 5ate,
Does applicaM wm popeM1y in arry dha
caunry in Ind�arm7
❑Yes ❑No
Deduction approved in tAe amounl of:
2b
sigrawre ot Counry FwdAOr
�
/ Con� udebtedness unpaid as of March 1,
ar / S�G. 0'6d
f wrt�ed wN� sortreone aU
dly, stefe. md LPcaOe)
yes. whffi couny?
�
/ Record mimbet Page mtmber
08 aa-8�t
�s u,e appurvn� �ne sde �ega� or eq�ltaae rnmen
❑Yes ❑No
r Uwi spouse. �cate wi�h whom.
Is Ihe propeM1y in 9uestion:
❑ Real Pruperty ❑ Mobile Home QC 67.
V
Wtal Tering Disirict7 ' Has Uus dedudian bcen requested on property
for amen� yeaR
. __�__nv�__�No
�o�NnA�oROR�rawer �0: _
;ard �^ � �-�- a..a...�=��}
�= r � / y6, ? ��, SI � —
Counry
Oale (rmnN. day, yea�
I/ We certify under the penalty of perjury ihat ihe above and foregoing infortnation is true and corred and that the appGcanls was / were a resident of
Indiana and ovmer of the aforemen6oned property on March 1, 20
In3� (opners I�AI nama) / , Dale (mon/h. daY. Y��
�tlent address of appliEaM (n�unber and sLee1
I 3 8 4 � ��- s c..�
IC G7.142-.07
pelsan (num6eraM streel, aty, sWe, anO LP mde)
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