HomeMy WebLinkAboutMortgage_Smith (6)E•::�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship � Year
.°� ' FOR DEDUCTION FROM ASSESSED VALUATION
:' i :
�� S�ataFOrtn<;i09�RN/6-09)
r Prescnbed by Department of Local Govemment Finance
File Mark
�NSTRUCTIONS:
To be filed in person or by mail. �° "^�
Filing Dafes: i) Real Property: Musf 6e completed and dafed in the calendar year tor which Ihe deduc[ion is oughf. � C Auditor
Mus16e filed with the CounryAudiror or County Recorder o/ fhe counry where the pioperty at
on or belore January 5 olthe immedia[ely succeeding calendar yeac A p� .���� County Rewrder
2J Mo6ile /Manufactured Homes not assessed as Real Property: Musf file wifh fhe CounryAuditor o/tp�
county where the property is located dunng 1he nvelve �72) months before March 31 of each year fhe
deducfion is soughl.
See 2verse side lor addifional instrucfions and qualilcafions. C�����
Apptirant�owneiwconfrdaDUyensegresbictiansarreverspside) � '_! . . __._.___
Assessed vaplu�e of real pmperty as ol
� c�'(-1,Y/ o0
Ifno,�Matis /�erexaqshareol
If name on rem�d rs
Nama oi�
AGCress ot mwtgage
Name Of assignee ai
ACtlress ot assi9nee
�m � �tti, �.- i
numbeN I al tlesuiplion
lo -a�3- � I alpo -
IMortgage / ConVaG iMebtec
March 1, current year
nva uer
(r n
convact seller (nambei
oNer owner
state,
as
d�. K .
�1. �a�-
C
wmeone oUer
legal w�Y itable owneR
d 0 UV Yes ❑ No
ouse. indicate wiN whom
Is �h property in question: MnualtyASSessed
[3RealProperry ❑MnualyASSessed
S�to �
'Dces aOD���nt own property in any otner I( yes. w�at counry? What Tazing Oistrict7 Has Nis Oetluclion �een requestea on prope .ry
caunryinlndiana? r-/No forcurrentyea/1
� n Yes IJ ❑ Yes ❑ No