HomeMy WebLinkAboutMortgage_McDonald^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear
__ . FOR DEDUCTION FROM ASSESSED VALUATION
. �e�����R,,,�> �I
S y„ 1 Resaibee by oepanrtient of �aw covemmem F'irarce
File Mark
�STRUCTIONS: �I�'n11 F����:
k 6e filed in �d
person w by mail with the CountyAuditor or County Rewrder o( fhe counry whe2 the p��y C_
Filirg Dates: 1) Real Pmperty: Must �de durirg Ne year for which the deduction is soughL �,.� .T4� Counry Auditur
2J Mobde /Manufactuied Homes rrot assessed as Real Pmper7y Must Ae dunng the IweLNe�7;2J,A v V�� County Recordu
6efwe MarCh 31 o(each year fhe deduction is sought.
See reverse side tor addifional instructions and qual/ficatbns. uNTY qUD�
AppG�nt(owr�eroro9waabul^er-�ueristrirbor�mrcve�ust�) M� n n . GI
i�.u7
his l icer eraU share of infelest?
-/�"�- oo Qoc a`%3 a�
�e / Can6aa cdebtetl�ss unpaid as ot MMgage / Contra
. a�rent year eate ot appfication
If name m remE is 6Rueni than ihat o( aPpfran4 h�d'vate bebw
Nym¢ of mwtgagea or convact seller
o( �rort9a9ee w wntracl uller (number and sLee(, ciry. smre, an0 ZIP cade)
ass�ee w aNU owner or MIAer N martgage
of assignee (number arM stree4 �1: s1Ete, aM ZIP ootle)
Does aQplkam w.n pmperty in any oUer I If yes.
�,�uy��ioa�a r� .,__ n .,_
zo
Sig�anrte of
2°— � z°—
It owned wiN somea�e ottier than spouse.
COUN7Y AUDfA
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Counry �
Record number � Page numbel
I5 tlre property in questi[
❑ Real Properly ❑
Yes LI No
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t Y��``CY '� ���,••'••��
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yea�
i/ We certify uMer the penalty of perjury that Ne above arid foregoing infortnatlon is We antl corrert arW that ihe appliran[ is a resident of IMiana and
owner / mntracl Euyer of ihe aforemenlioned propeM1y on date appiiration is filed.
uaWre (ownefs lW �mnre) A A Date (morvh. daY. Y��)
exewted Power af Altomey m by IC 61
Pdtl�s af autM"¢ed persa� (number arM sDeet crty, sfafe.
Daie (monfh, daY• lea�