HomeMy WebLinkAboutMortgage_Hollars"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
__ __ FOR DEDUCTION FROM ASSESSED VALUATION
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�' �«. Reuribed Dy DepartmeM of Loral GaremmeM Frenre
INSTRUCTIONS:
To be filed in person w 6y mail witA the CountyAuditor or Counry Recoider o! the counry where the property is located. Ffi�j �
FiArg Dates: i) Real Property: Must file dunng Me year fo� which Ne tleduction is sought. 0 Counry Audiwr
2J Mobde /Manufactured Homes rrof assessed as Real Property: Must h7e during fhe fwelve (72) rtronths
before Maich 37 oleach yearthe deduction is sayht ❑ nry Recwder
Sea 2verse sbe for addrtiona! inshuctions and qualificafions.
I noofiwnt t r r- aee msvirinrss m lamsse siea�� �. � .
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1, p1Rnt yYdr
uhat is his 1 her eraG shara of Interesl?
� m Rcad is Qifemnt Nan Nat W aDW
W rtarnjagee a oontract se�er
�-o�—� —ocx�. � ._._... o .-°_ oaa
aa 4Webtedness unpaid as d MMgage / Contraa'uMebted�ss unpaiE as d Is the eppi'xant Na sola
ye¢r/ �vV Eate of eGP�� �' � Yesk v^'^rYl
i:�( ❑ No
If owned wim wrneane dher Ihan spouse. indimte with whom
oontract se0er (number and sbee; ciry, smte. aM ZlP cade)
Name ot assignee a oNer ovmer m hdEU of mv�age
AdC2ss of assiqnee (wm6er entl atreeL �: sta�. aM
wm yoperty in afry
Y AUDROR
Dedu�fion approved in Me amount ot j �� O
Is tlre V�VertY in Que5lion: MnuaOy AssesSeE
❑ Real PmPenY ❑!!rm!�aq'Asse��
dudion been re9u�tee m ptopeity
�n ❑ Yes ❑ No
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I I We certify � ,�� a L ..,regoing infortnation is We and cortect and that Ne applipnt is a resident of IrWiana and
owner! mntraa � �� .,n date appivalion is filed.
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