HomeMy WebLinkAboutMortgage_Hulfachor�
"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vear
= FOR DEDUCTION FROM ASSESSED VALUATION
� sra�e r-o� aa�w tR„ i s as>
�' Presoibed Ey Departrtierd o1 Lmal Gwemmerit Fuance
ie
INSTRUCTIONS:
b be filed in person w by mad with the Counry Auditw or Counry Recorder o( the counry wHere fhe property is located. � z 0 �0
FiNng Dafes: 1J Real PropeRy: Must ke during the year for which the deduction is soughL � Counry AuEitw
2) Mobde / Manulactured Homes rrot esse.ssed az Real Property: Must h7e dunng Me hveNe (72) monNs
befora March 37 0/ each year the deduGion is sayht. C� Rec°rde�
See reverse side /or addilional inshuctbns and qualfiwtions. GIB
I�"n11( � 1fY'LA L 6 T$�► N 1��'/"1/.1�L�e \1 A 11 e ���1�/ L..
�vaNa oFreal P�Y es af
1, qrre�U year
If ro. what 5 ha I hu euG shara o
If name m famrtl a Grteant 4�an tl
- v
Mortpage / Cantraa u
Mert�h 1. a�rent yrar
�tant UiCkata bebw
�/'L�QC,µon er(n�to
l{ /`I �� �
��p�yj�n ✓
�D/�-���
� /
amounl oE
2p _ � 20 - � 20
aid
,
.iutcounty?
20
Q�.��d—
unpaid as of Mang:
someone other than
20 _
f
RecrnE rwmber Page rwmbu
/o o33�I
unpaie as d b Na epp&snt tlu s�
� I ❑ Yes ❑ No
mdimta with wtnm
openy in Questim: MmiaOy Auessed
tl P(oPeRY ❑ MmualN A�sed
MoWle Fbrne QC 61.1-i
)� Sl�, 33- 3-i/
Has Nis deducUm Oeen re7uested m propesty
tm current yra(? ❑ Yes ❑ No
��1�
;naWre d CmmbAWitor I Counry I Date (rtrmfh. tlaY•Y'��
I/ We certi(y urWer Ne penatty ot perjury that ihe above arW foregoing infortnation is true and cortect and that ihe applirant is a resident of InEiana and
rnmer / contract buyer of the aforemerrtioned property on date applinlion is filed.
nuevelowrerShAramel . / /% ir Date(rtunN.daY•Y�A
Ku0 resitlent aEdr¢ys U appfrant (numberand sLee4 �'nl: state. antl LP oode) � g
�oo�,rsy ouo w, �T 6�,r„�. �f7 `E
paspn auNOr¢M Oy GAy exew:eE PoAe� of Ai�meY a�' IC 61.7-72-0.7
fdErm af autlwr¢etl p�son (numDer aM stree; tlry. stafe, and LP cnde) .
�y,�