HomeMy WebLinkAboutMortgage_Spindler (7)^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Cou vear
,_ : FOR DEDUCTION FROM ASSESSED VALUATION
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�• ! Resaibetl GY Departrt�ent of Lnwl GovemmeM Fuanca
ur
le Mark
�STRUCT70NS:
Fortn wi :
b be filed in person w by mail wifh the CountyAUditor or Counry RecoNer o/ the oounry where fAe pmperty is located.
Fii'mg Dates: 1) Real Pmperty: Musf file durirg the yearlo� whicA the deducUon is sought. ��� �— Aud'rtor
2) Mo6de / Manulactured Homes rat assessed as Real Property: Must fiie dunrg the tweHe (12) months ❑
6efae March 37 01 each year Ne deduction is sought. �0��
GIBSO
See reverse side Ior additanal instnictbns and qualificatrons.
MP��� (o�T1eI or conlraC buyer - see reshirbpys m reverse sde) i� � . n
f vWUe d rnal properq as ol
amnt year
no, what is his / her exaG shara o( intrlest?
-a3- � - o-[bl.a�l-P�
Mortqage /��COnlrarl intlebtedness unpaid as ot MwigageeP Con� 'viEebtedness unpaid as of
Mar�
It name on rt<md o drtfrmnt Nan Nat of app6cant u�Aicate bebw:
Name of rtqrt9a9ee or mnbaa sWer �
�
Pdtlress d mortgagee or contrad se0er (munber aM streeG �Y. sbte. aM 2
or «ner owner or hdaer af mwigage
of astignee (number arM stree4 a+1: ��e, and Z/P tode)
Does eDDliqnt ovm property in any oNer
munry in IMmu?
❑ Yes
Dr�ucom appoved'ci Ne amouN of:
� �
Sig�aMe W CamNAUditw
Yes LI No
If owrtd wi� somea�e dMi ihan spause.
�- Is Me propeny in Qunstion: MnuaOy Asussed
❑ txe� aoPenr ❑ an^u�ya�ea
Modle hiome pC 6
5 P11���E2, Qc���'E —
. . a�E�ala- _
��
05� �08 y -
� �/3 �t3RuIC' . .
COUNTY AUDROR
20_ � 20_
Counry
�i��iY
20
�
I/ We certify under the penalry of perjury that the ahove and foregoing mfortnaGon is W e and cortect arW that the applirant is a resideM of Indiare aM
r/ mntracl buyer of Ne afwementioned property on date appliration is filed.
I (o rY f�nartre) � Date (rtuNl�. EaY.Yaa�
�, �o-ao- i �
o�ni atltlrcss W aoolrcact f�unber �rli1 strecL citb. state. and LP ootlen
executed Power d Attomey
Addmss of autha'ved person (number aM sbee(. dry. sbte. and ZIP mtle)
Date (month. OaY. YEa�