HomeMy WebLinkAboutMortgage_Kendlea°'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
_ FOR DEDUCTION FROM ASSESSED VALUATION
s�a Fam az�os �Ra i zo»
�' � Presrnbed by Department of Local Govemmenl Finance
File Mark
INSTRUCTIONS:
To 6e filed in person or by mail wifh the CoulrtyAuditor o/ fhe county wheie the property is bcated. iV�QY � Q [ �(12�
Fda�g Dates: iJ Real Roper(y.' Dunng fhe 72 months be/ae June 17 of lhe year the deduction is to be etlec6ve.
2) Mobile Homes assessed under IC 6-7.1-7: BeAreen January 15 and Maich 2 0( the year the deduction is-tn be eflective.
See reverse side for addiGonal i� c6ons a�d qu� lificaf� ns/ �(P �.Q �
C/
value of reafpapaty as
t is his / Icer ezacl shart
nu r I 9al dFj�^!O—W �/' �l C-Cl �V I' O� �/o� /
�
1. aaren r Mortga9e / Coniratl indebtedness UnPaid as Of MarCh 1,
artent year �� O �-�/'�
C.�V
ihal d appliranl iMiple below:
or caNacl seller
Address of moM1gagee or
and street, dty, Aafe, a�M
Name of assignee ar oitier owner w holder M rtrort9a9e
Address of asvgnee (numbuand sLaeL dty, sfate, aM ZfPOOde)
Deduction
�
mmpopertyinarryolhu —�.�'��
�' ❑Ya^- � ���1 ��
wed in the �� �
� �00
. ^��j ���lo
{y dilor �/" � ' j Ca
I I We certiy under t1�E penal
Indiana and owner o��ie afoi
$ignaWre (owne/s M1dl name)
\ sdent addrws of appl' �(n
� n
Perwn autMr¢ed by duy exewled
Adtlress of aWwraed person (num
�t Ta�ing Distric
7R
�
swa �ega� «eq�ivae owr�en
❑ Yes ❑ No
Ihan spouu, indicate with whom.
Is Ihe property in question:
❑ Real PfopertY ❑ Mobile Hane QC G7.
duction been requesled on yopeiry
y�n
❑ Yes ❑ No
20 20 _
Date (monfh. day, yea� „
perjury th��he above and foregoing infortnaGOn is true and wrrect and that ihe appGcants vras I were a resident of
ntioned property on March 7, ZO �. _
G� \ \ X/\
city, ate.aiMZlPmde�)J� [�
S�LLY� �U. (�Y/
� a �y i� 6,. 2-.��
r. stafe, arM ZfP code)
Dale
L9
7 �7
(mmfh, daY. 3'��