HomeMy WebLinkAboutMortgage_Higar�
STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S,«. i s�are F«m a3�os �RS i a-03> � � �----`
i� Presaibed by Department of Local Gtivemment Finance \
h
. -ai�
iNSrRUCrioNS: MAR U 5 gp��nnan�
To be filed in person or 6y mail with the CounryAUditor of the county wAe2 the property is loc ed.
Filing Dates: 1) Real Property: During the 12 months before May 11 0/ the year the deduction�'to be eflective.a
2J Mobile Homes assessed under lC 6-1.1-7: Between January 15 and Ma�ch 2.W-tha.yeaititAe,dedycfro�h�effective.
See reverse side for additional instructions and qualifrcations. � ��uSGtJ C�U� � y;,UDIiC' ;
Applicant (owner ct buy - e 2sfrictions n reverse sid )
Taxing ' rid Key number / leg I descrip' Record number Q
Oly _ l �' /�� Page number A �
lJiv v Yr��(,J �6
Assessed value of real properiy s of Mortgage / Contred ind�tedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1�yrrent year l/ �'0 0� owne(? ❑ Yes ❑ No
�� 'C
If no, what is his / her exad share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than lhal of applicanl, indicate below: Is the property in question:
� Real Property ❑ Mobile Home (IC 61.1-�
�me of moRgagee or contrad seller � �^
�/V`
Address of mortgagee or conVaIX seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, sfate, ZIP code)
Does applicant own property in any olher If yes, what county? What Taxing Distric[? Has this deduction been requested on
county in Indiana? property for wnent year? � Yes � No
COUNTY AUDITOR
Deduction approved in the amount of:
20 Q� 20� 20 20�� 20 Q_ 20 20
� � P
Signature County Auditor � Date
�I We certiy under the penalty of perjury that the above and foregoing information is true and corred and lhat ihe applicants was / were
residenl of Indiana and owner of the aforementioned property on March 1, 20
' nature (owner ll name) Person authorized by duly executed Power of Attomey
� �� or by IC 6-1.1-12-.07
F,uII resident address of appli "nl Address of aulhorized person
��� � z �' 7Y