HomeMy WebLinkAboutMortgage_Allen (3)�,
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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r PrperiDeO by DepaNrent of Local Govemment Finance
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INSTRUCTIONS: /�PR F�A�v1er►n3
To be filed in erson or b mail with the Count Auditor ol the coun whe2 the ra e LUU
p Y y ty p p rty is Ixated.
Filing Dates: 1) Real PropeRy: During fhe 12 months belore May 11 0/ the year the deduction is to b�eflective. � %�
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and Maich 31 0/ th eac,the deductia'o�is to be%B�tive.
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See reverse side foradditional instnictions and qualifications. p�7p�
Applicant (ownerorcontract buyer- see restrictions on reverse side) � .
Taxing Distrid Key number / legal description Record number O�
� Page number
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant th sole legal or equitable
March 1, wrrent year March 7, curtent year ownef? ❑� ❑ No
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If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate wilh whom.
If name on record is different than that of appliwnt, indicate below: Is the property in question:
� Property ❑ Mobile Horrie (IC Cr1.1-�
ame of mortgagee or contrad seller
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Address ot mortga e or conhact seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county7 VJhat Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for current yeaR O Yes� No
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COUNTY AUDITOR
Deduction approved in the amounl of:
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Signature County Auditor Date
��/ We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
;resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person authorized by duly executed Power of Attomey
• or by IC 6-1.1-12-.07
F I resi ent address of applipnt Address of authorized person
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