HomeMy WebLinkAboutMortgage_Jones (5)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
�__„ • POR DEDUCTION FROM ASSESSED VALUATION
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�' ,w 1 Presaibetl by DeDartmeM of Laral Govemment France � p���
d File Mark
�VSTRUCTIONS: �
To be filed in person w by mail with Ihe County AudROr or Counry Rewrder of the tounry where he property is located. F� ��
Fil'mg Da[es: i) Real PmpeRy: Must file durirg the year fo� which the deduc�� q s�hL20 �� County Auditor
2J Mo6i�e / Manulactured Homes rrot assessed as Real Prope `61Gst le dunng the M1veNe (12) months
before March 37 0l eacA year Ihe deduction is sought. ❑ County Recorder
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See reverse side�ditional insfructions arM oualficatbns. l\ c\
Key
�o�
Mr e� share of interest?
Name of mort9agea or mntrap seller
COUN7Y AUDlTOR
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oll 561�1
�19a9e / Con ness un7aitl az d Mwt9a9e / ConvaG rcMe6ttbnrss unpaiC as of Is Ne ePP�ifarrt 1he sde
Marti� 1, airte / date of appOcafion legal a eQuita6le ownef!
�/ �� �� ❑ Yes ❑ No
If o+metl wiN someorre ofher Ihan spouse, indimte wilh whrnn
Pdd2ss of morigagee or contrar2 se�er (number arM streeS Fdy. state, artl ZIP code)
Name of assignee w otMi owner or hdder oi nprtgage ,
/
Dces applimnt oMn prope�ty i�ru��
munty in IMena? r— \\ � , •
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c�`a �`t�''
���/ �\. r�.i�Y1n /I A .O
v? Whai Taring DisMp?
�ouNrrnuoROa
20 20 _
Counry .
h Ihe property in Question: MnuaDy Assessed
❑ Rea� P.ocertv ❑ amua�yassessed
Has Na detlutlion Eeen reGUesteE m G�W�Y
far arrem `l��? ❑ Yes ❑ No
20 I 20
I/ We cen . vie penalry oPperjury that thc�bove and foregoing infortnation is We and cortect arW Nat the applinn[ is a resident of Indiana and
owner / mn .act buyer of ihe afwemeMioned pmperty on date applira5on is filed.
�naam (nw�o/c hd ryq9�� Date (month. d3Y. Yaar�
msident aGdress of appfrant (num0erarW sheet bty. state, and Z!P aode)
u,
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Address of auUroe'ved pe5a� (numberand sbeet �Y. sbte, and ZIP code)
Date (mmN. daY. Y��