HomeMy WebLinkAboutMortgage_Mann"�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
- • FOR DEDUCTION FROM ASSESSED VALUATION Coun(((��� -T`+awnship_ � Y`ear
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� PrescribeC by Department ot Local Govemment Finance
25 3
INSTRUCTIONS: File Mark�
To be filed in person or by mail with fhe County Auditor ol fhe county whe2 the property is located. « /�
Filing Dates: 1) Real Property: During the 12 months betore May 11 0l the yea� the deduction is to be �c e. /�/'u^^��''�� (//
2) Mobile Homes assessed under IC 6-1.7-7: Behveen January 15 and March 31 of the year��de�ticfion fs�to'be eHective.
See reverse side /or additional instructions and qualifications.
Applican ner or ontract buyer- ee restnctions on 2verse side)
Taxing 'strict Key nu er! legal description Record number O
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A ssed value of real property as of Mortgage / Contrad indebtedness unpaid as of is the applicant the sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned wilh sameone other than spouse, indicate with wnom.
If name on record is different than that of applicant, indicate betow: Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.1-�
' ame of moAgagee or contrad seller � 2
d
Address of mortgagee ar contract seller (number nd street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sfreet, city, sfate, ZIP code)
Dces applicant own property in any other If yes, what county? What Tauing District? Has lhis dedudion been requested on
county in Indiana? property for current year?� Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 � 20 � 20 �� 20 �
o �-- P
Signature County Auditor Date
i/ We certify under the penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20
S' nature (owners full name) Person authorized by duly executed Power of Attomey
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Full resident address of applipnt Address of authorized person
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