HomeMy WebLinkAboutMortgage_Sparks (3)a°"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ship Year
_ FOR DEDUCTION FROM ASSESSED VALUATION � ,
s�e F«m a3�o9 (ae r 20» �
�' w„ f Prrsrnbed by Depariment of Loral Govemmant Finance it�? Al— �.
� � 1 �LUUOFile Mark
INSTRUCTIONS: OC
To be filed in person or by mad with fhe CourttyAuditor W the county where fhe propeAy is bcated.
Fd'vig Dates: 1) Real Property Dur'v�g the f 2 months belae June 17 W fhe year the deduction is to be el/ectiv�. t`'�� � �-�1_
2) Mobile Homes assessed under fC 67.7-7: Between January 75 and Maiclr 2 of the year the de�cuav�risYo�De�e7ective.
See reverse side for edditional ins6uctions end qualifitations. V NTy pUDITOR
.,�ncoN COU
er-see
4
9dB�
� " - a - -a�-ooG. �`1 -oa�
��r ��y as or nwd, i. a.�u y�� Mon�ye i co��aa mae�ea�u ���ab as o� n�arcn ,,
anraA year
a
t is hs / her exact share of interest? If owned wM sortreme a11
If rrome on recad is dit(mart Ihan Ihal of applicanL
Name
rtaRqagee or
and 9ree4 tlty, stafe, ard ZIP code)
Nartre af assgnee a dher owner or Mder of mort9a9e
Address of asvgnee (rcrtMer arM sbeet. dty. 4ate, and
Daes apdicaN wm property in eiry aher
cwnry ui Indiana?
❑Yes ❑ No
Deduction approved in �he amwnt of:
20 _Q� 20 _
� —
SignaW re of County Auditnr
yes, whal counry?
Recwd number
012q1➢�2a00M18�
❑Yes ❑ No
spouse. iMicate with whom.
Is the property in Ques6on:
� R�I ProoerN ❑ Mobile Home OC 67.
- ys�
. . Dra��'er 1O�.Q:?.g-�.
�n property
/
.. .... ❑ No
Card ��' .. '
couNTr auoRO,
20 20 20
CounH
20
Date (monfh. day,Yea�
20
I/ We certify under Ihe penalty of perjury tliat the abwe and foregoing infwmation is true and corred and tliat ihe appticanfs was / were a residenl of
Indiana and owner oi ihe aforemen6oned property on March i, 20
vssmvP lrnvnrfs hIl name) Date (monfh, daY. Y��)
address o(
Person aulfar¢ed by duly en�
Address of aNhw¢ed persm
s6eeL aty. Sfdfe.
67.
street Wy, state. aM ZIP oode)