HomeMy WebLinkAboutMortgage_Hale°^� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
� FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fam 43709 (RB / 2-07)
�6 ,.» � Prasmbetl by DepaNrt�enl of Loml GavemmeM Firence
rNSrnucnoros:
To be filed in person o� by mad with the CourrtyAuditor o/ the courrty where the property is bcated.
Fding Dates 1J Real Property: Dunng the 12 months before June 11 0/ the year tlre deduction is to be e/(ective.
2) Mobile Hanes assessed under IC 61.7-7: Between January 15 and Marclr 2 of fhe year the deducliop.js k Lq e6eafitp, 9
See reverse side /or additional insWctions ard qualifications. 1' C[3 G 4 CU u
icaN rcr ���y eere ' on+eversesde /�
� ( I /l . .���' � n � �O�n N
,a � .a,,.W„ a(a - -aS-�FOO-ODO•% �3 -
nssessea ralue af re� popeny as 2n �, a.rera rear MonAage � �aac maewedr�ess �n,pab as ot nlarcF, �.
aR�,� 0$�O
If i�.t is his / her esact share M imeresl? If oxned wilh someone otl
If name m recwd is difterent thari Ihat ot applicanL i�mle belar.
Name of mwtgagee or odiUacl seller �
ndd.ess or imnyagee « mntrae sdle. (iwmber and street dA: srare,
Nartre of assgnce a alher oaner w hdtlet of mMga9e
(rMxn6m ard sLea1, city, sfafe. and
I Daes applicaN own property in ary otha
counry m Indiana?
❑Yes ❑No
approved in ihe amount of:
��_��
Whel Tadng Disiridl
AUDITOR
20_ � 20_
�--�� - � � o� 3s
is me a�r�,� u» sde iey� «�uae o«nen
9
❑ Yes ❑ No
smuse. intlicate with whom.
Is Ihe property in questian:
❑ Rea� Property ❑ Mobile Home
20
�esled on praperty
❑ Yes ❑ No
20
reture nty Auddor Camry Dale (rronlh. d ye �
O�-� 4�0�
I/ We certfy under alty of pe u ihat ihe above and foregoing information is true and cortect and that tlie appiinnts was / were a resident of
Indiana and owner afwementioned properfy on March 1, 20
��.��.a� fo eir�.ar�� _ DatelrtronN.daY.Y�A
slate, arrd
� P�rson aUlMxized by duy exewted PoWef of Allmtey of by IC 61.1-72-.07
PAtlress of autturaed pason (nurti6er and s4ee( U}; sdte, arM LP code)
47