HomeMy WebLinkAboutMortgage_Spear"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ouu z s p Year
�__ . POR DEDUCTION FROM ASSESSED VALUATION
- Sfate Fatm A3709IR71 / 609)
�' ,,,, � Presaibe0 Oy Departmerrt ol Laml Govemmenl Friance
F"le�
wsrRUCnoNS: DEC
To be filed in person w by mail wiN Me CountyAuditor or Coun y Recorder o/ the county where the property is located. F� fl� �:
Fifing Dates: 1) Real Property: M�st fde durrng Ne year for which fhe deduclion is sought i Counry Auditor
2J Mo6�7e /ManWaUUmd Homes not assessed as Real Properly: Mus[ file during Ne lwelve (12J months�l � 1�
befora March 31 of each year the deductvn is soughG CLW nty Recorder
See reverse si0e foraddifi,Wnal instrt�ctions and qualifications. pjB9ON C AUDITOFI
��L�L���� . f i i �
i, •/ �/ � I
Y real qoperty a of Mortpage / Conlraa iMebte��ress un0ai0 az W Mongage I Cantraci indebtetlness w�G� as d Is Ne ePO�� the sde
year Mamh 1, arten yeer tlate o( aOP�� Iegal n equitada owneR
�� ��� ❑ Yes ❑ No
/ Mr eract share ot NteresiT tt o+med with mmeorie other ihan spouse. Indicata wtth wlwn
Ih2 PfOpCrtY N VUM.bOn: MIIIIJPf ASSGSSEA
eal ProPertY ❑ !�^^!�,Y�
rtnrtga9ea or
Pddres of �ratgagee w mntraa se�er (numbv and street, cdy,
Name af asvyiee w oCrer owner or hdEer d mortga9e
Adtl�ess ot assignee (number aM shee4 �'#1: slate, entl LP cade)
Yes �� ❑ No I If Yes. what counfy? I Wl�at Taarg oistrkt? I for w�rent � been Oested m 7 ❑ No
COUNTYAUDROR
Detluqivi approued in the amount ot.
20 20 _ 20 _ 20 20 _ 20 _ 20 _
Signanne ot Camb AuEiwr Counry Date (rronth. daY. Y��i
�I I We certify under the penatty of perjury that Ihe above and foregoing infomation is We and correct arM that Ne applipnt i5 a resident of Indiana arHf
rnmer / mntraq 6 r ot ihe aforementioned property on date application is filed.
Sig wners fiA e) Date (rtmlh. da . Yee�
la aa o2r>/d
FWI iesident aE�ess of a t(num6erend sbee( vt}; state, and Z1P codeJ
479 5. Jo L.2�� 5�1�- �n '�7��
Pusm autMr�E by ditly �ecuted Pwer allvfornay w by IC F1.1-12-0.7 Date (rtm�h. daY. Y��
ldEress W aW�u"¢e� person (numher a� 5bee4 dry. sbte, end ZIP code) .