HomeMy WebLinkAboutMortgage_Friedman°'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
FOR DEDUCTION FROM ASSESSED VALUATION
- s�ia F«m aa�os �r� i zv�>
�' J Presoibed 6y DepaM1ment of local Gavemment Finance
File
INSTRUCT70NS:
To be filed in person or by mad with fhe CouMyAuditor o/ the county where the property is located.
Fding Dates: i) Real Properly: Dunng [he 12 months befare June 17 d the year the deduction is to be etfective. ppp 7 ��
2) Mobile Hwrtres assessed undei IC 6-1.1-7: Behveen January 15 and March 2 olthe year the deducGon is (D 66�efftcWe2�0$
See reverse side /a addifbnal insWCtions arrd qualificafions.
at is his I her ezad share ai ii
/
on record is d'A(erenl Ihan tha
f mortaacee or canUacl seller
num6er l degcil�n� a IS-acn-c�o 3.3`��-na� Reoordnumby� P��/ /
Ot (J
7, cureM y�r AAorlgage / irWeb�etlness unpaid as of March 1. Is Ihe app6ont Ihe sde legal w equta6le owne(.+
airtenlyear ^ O O �
� j� ❑ Yes ❑ No
st1 If wmed with someone dlrer Ihan spouse. inddcate with wlmm.
in6cate belax:
Address of moRga9ae w conlrad seller (nun6d eM sfreet, dty,
Name of assigrice u Wiei awna w
���a�9��,�a,�- a��:
,
Doas applicanl � � Q,� �� � - . . .
�,��,��re o,�� �a�q:.�
���a� ��a�,�cn • -
Deduction aPC�'+� ir. n "-
"D � �
2p � � N � 20 _
20
I I We certi� under penalty o( pe tliat Ne above and foregoing
Indiana and owner f e aforemen property on March 1, 20 _
7na _ o er name) _�% _ Y/
of Altorney or b"y IC
of aulhor¢ed pelson (num6e� arM shcet, rdy, state, aiM LP mde)
Is ihe propeM in question:
O Real Property ❑ Mobile Home
VJhal Tating Disincl? Has lhis dedudmn been requeste0 on property
r« wR�,i �n
❑Yes ❑No
1UDITOR
_ 20 _ 20 20
C n Dale (rtwn tla , yea�
O -1�/-0�
aho� is true and mrreci and that the applipnts was / were a resident of
�Y• Y��)
Date (lrmnfh, tlaY.