HomeMy WebLinkAboutMortgage_Lamey (12)".a °^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Year
FOR DEDUCTION FROM ASSESSED VALUATION
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�' � Presrnbed by Deparlment W Local Gavemment Firence �
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Fi e
lNS7RUCTIONS:
To be filed in person or by mad wrth tlre CourrtyAuditor o7 the courrfy where the property is located. �!�
Fding Dates: 1) Real PropeAy: During the 12 rtronths be)ae June 77 d the year the deduction is to be eliective. a �'+'�
2) Mo6de Homes assessed under IC 67.7-7: Between January 15 and March 2 o)the year tl�e deQ({y�4�L is fo �eAectiv�!
SeereversesideloradditionalinsWctionsandq�alifications. �"O,�1N COUNTY AUDITOR
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T'rg DisttiQ K7�� �V'-� ����3 � D- p p D. �6 - o� y R O number Page rwmber� D
O� �
rWUe of � poperty as d March 1. anen� ymr MaABage / Contracl indeWedness unpaid az W March 1. Is Ihe appFmnt Ihe sde Iegal w equilade o.rrren
. ainerrt ye.ar
99 oov ❑Yes ❑No
If�al is his / har ezad share of inlerest? If awned with sortreona olMr Ifw� spause. in0icate with whom.
If reme on record is d'�Herant than ihat ot appicanl, ind�te belwr Is Ihe propeM1y in queslim:
❑ Real Properly ❑ Mobile Horne (IC 61.
Nartre of rrorlgagee or conUaU seller �� ,�
ot mortga�ee n oonUaa seller (iwm6er and 5ree4 dry. sfa(e. arrd
Name af assgnee a dher onncr a hdder of rtwri9a9e
Adtlress d as99nee (mmber arM street. cily, sfate. ana
Does epplicard own proparty in arry other
couNy in Indiare7
❑ Yes ❑ No
DeducGon apprwe0 in Ihe a+nwnt of:
20 �9- Z(1_
f��
SignaW re of Counry Audilur
li yes. what camry? `/�ml
couNrrauon
20 — � 20
Ca+nb
D���„���- ��o.:.°..9.-.rG a
Cal'd NO. �
.....................
20 I .. 20
20
�
� No
I/ We certify under the penally of perjury that the above and foregoing infomiation is We and correU and ihat ihe applipnts was / were a resident of
Indiana and owner of fhe aforementimed property on March 7. 20 _
Perwn
of Pltnrney or by IC 61.1-12-.07
oFautMraetlperson (numbe,aMS6aetaty.sfate,
Date (monlh. daY. Y�h
day yea�