HomeMy WebLinkAboutMortgage_Goldbachs°'a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count 7ownship Year
FOR DEDUCTION FROM ASSESSED VALUATION
. � � ' Slate Farm 43709 (R8 / 2-07) �
�' ,,,, f Presmbed by Departmenl of Lacal Govemment Finance
File MaAc
wsrnucnoNS: MAR 3 1
To be filed in person or by mad with the County Auditor o/ the county where the properly is located. 2 �� 8
Fd'v�g Dates: 1) Real Property: Dunng the 12 months befae June 17 0l the year the deduction is to be eRective.
2J Mobile Homes assessed under IC 6-1.7-7: Befween January 15 and March 2 0/ fhe year the deduc6on is ftrbA,BBecGv�,�
See reverse side fa additional instr�ctions aM qualificafions. l� ��a� <<3
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Key rwmber / Iegal tlescri�
- S-3 -
Mardii.arrentyear Mor
af inte(cst?
rernrtl is diReranl than that of appicanl indiote below:
Name ot mortgagee or cantrad seller
L � _ /) (
Address of mortgagee a contrad selle� (num6erarM sfreef. aty. stafe. ard ZlPcode)
Name of assignee aWier o.vner w hdder of moM19a9e �
AAOress of assigrree (number aM streel. dty. stafe. aM "^ __.._' —
Do� aPplicanl wm property in eny dher
caunry m Indiana?
❑ Yes ❑ No
Dedudion apprwed in Ihe amoun� of:
20 20 �
P
Soreture of Counlv AuSM�
az of March 1,
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i � � '� '
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D�-�„�,� .o...ao�7.......
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' �ICo3�a�o.a0/
2� � 20 � 2�
Page r
S
Is ihe appfimnl lhe
❑ Yes ❑ No
spouu. iMicale wiih whom.
Is Ihe propeM1y in questim:
❑ Real Pmperty ❑ Mobile Home (IC 61.
Has lhis tl�
'w arrent
20
uestetl an property
❑Yes ❑ No
oate �ma,u,. car. r�n
20
I/ We certify under lhe penalry of perjury that the above and fwegoing inforrnation is true and correct and that tlie applinnCS was I were a resident of
Indiana and ovmer of fhe afwementioned properly on March 1, 20
uuinrnlnwirfs IWlnamal / _ Date (manth. daY Y�A
and sGeet cXy, stafe,
Person au�haaed by duy ezealled Pawer Of P1IameY a bY IG['sl.t-l"1-.0!
V
Adtlress of aulhar¢ed person (number arM streeG aty, state, aM LP wde)