HomeMy WebLinkAboutMortgage_Grubb°°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship Year .
FOR DEDUCTION FROM ASSESSED VALUATION � ��' r
swe Form as�w (rte � z��)
S l PrasmbeC by DepaMient o( Local GovemmeN Finarr.e
HN
lNSTRUCTIONS: ii�p,l 1� �a�09
To 6e filed in person or by mad wrth the CourrtyAudRor W the courrty where fhe pioperfy is bcated.
Fding Dates: 1 J Real Property: Dunng the 72 monMs be7ore June if d Ure year the deduction is to be ellective.
2) Mobile Homes assessed urMer IC 6-1.1 J: Between January 15 end March 2 0l the year the deductim is to-fie�e�ictiv��
See (everse side /or addtional insWCtions end quaGficatrons. //'t
c
Aodicant (owner or wnhaU 4�Ye� - see restri�5ons m �9y�e sde) . .
T�� ' Q%��, a/a �,r�� l� - p D-() a�. 8 IQ D-o a 7 R�b o0
0.ssessetl rdue of real popaly aa ol Mardi 1. anenl ymr Afatgaga / Contrad inde6tedness unpatl as of March 1. Is Ihe appGcenl the sde I�
aR�, �• / �. (�. 4 -7 (P
If �what is his / her ezaa shara of inlerestT If owned wiU� wrtieone dhar Ihan spoux, indirate with wha
on
Nffi ol applicanl ir�Sin�e below:
Name of mortgagee or conUacl sellm
Addrrss M moM1gagea n
Name of assgnee w other oxner a
�kaM wm v�wem �� arry ane,
Indara9
❑Yes ❑No
dty, sfate. aM LP code)
dty. 9afe, and LP oode)
Y�.
� "
Deductian appmved in lhe amouM of:
20 ' 20 _ 20
SignatureotCounryAudibr � �
1/ We certiy und penalry M perj Ihat the above and faegoi�
Indiana and owner oi ihe aforemenfioned property on March i, 20
Sigrature (owne/s lyfl neme) .
A: .��-�
�derrt addrms of applicant (num6e and streel oty, state, erd LP mde) �
�( R � 4J,c�i�i�i� ��-� �t-c�..c
Person aWwraeA by duN �ecu�etl Poxet of fLLtaney d Dy IC 61.1-12-.07
Atltlr�safaWO'¢etlpersm (nwn6araMSbeef.d};sfafe.aMZfPmde)
Page rartnber
❑Yes ❑ No
Is Ihe propaM1y in quesUm:
❑ R�I Pioperty ❑ Moble Hane QC &1.
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