HomeMy WebLinkAboutMortgage_Folkmann� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Ye:
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� PresaiDed by Department of Loral Govemment Finance
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dN R�UCTIONS: � � ��Fil Ma�
Ta be filed in person or by mail with the County Auditor of the counry where the property is located
Frling Dates: 1) Real Property: During the 12 months befo2 May 11 o/the year the deduction is to be eff�lSve. ���QO�
2J Mobile Homes assessed under IC 6-iJ-7: Between January 15 and March 2 0/ tne year {fie'deduc io is o be effective.
See 2verse side for additlonal insbuctions and qualifications.
Applicant (owner or contrec uyeA r-^s-ee
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Taxing District
V
Assessed value of real property as of I
March 7, currenl year
If no, what is his / her exact share of interest?
on r�yerse srde)
Key number / legat description � Record number
March 1, current year
If name on record is different than that of applicant, indicate below:
mortgagee or contract seller
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;btedness unpaid as of
number
Is the a
owner?
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. ���niTOR 1
t the sole legal or equitable
❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
Address of mortgagee or contract seller (number and street, city, state, ZIP
of assignee or other owner or holder of mortgage
Address
street, city, state, ZIP code)
Does appficant own property in any
county in Indiana?
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Signature
approved in the amount of:
Is the property in question:
❑ Real Properry ❑ Mobife Home pC 61.1-7)
If yes, what county? I Whal Taxing Dislrict? Has this deduction been requested on
property for curtent year? � Yes❑ No
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COUNTY AUDITOR
I 20 ��
�
County Auditor
20 �� 20 _
P
Date
20
ceAify under the penalry of perjury that the above and foregoing infortnation is true and correct and that the applicants was I were
lent of Indiana and owner of the atorementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
�dent address of applicant � Address of authorized person
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