HomeMy WebLinkAboutMortgage_Mowrer_^�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count
: FOR DEDUCTION FROM ASSESSED VALUATION
. • State Foim 93709 (R71 ! 609)
�' ,,,, Presaibed bi DePanment ot Lmal Gwemment Foiarce
�STRUCTIONS:
b be filed in person w by maii with the CountyAuditor or Counry Recorder o! fhe county where the pioperry is located.
Fr7ng Dates: i) Real Property: Must fite during fhe year for which Ne deduclion is sought.
2J Mo6Ae / Manufectured Homes not assessed as Real Property Must file dunng the hveNe (72) months
6e(ore March 37 0/ each year the deduction is saght.
See 2verse snde /of addi�ional insfructnons arM qualfic�tions.
Key
A/&Ch 1. Nmnt YPar
II iro. wha� is ha! he�.
If nat� at tec�ld 6�
IJame of rt�ongagee « cantract seAer
ACdress af mort9agee or cmtra�l sW
/`
uWicate
�a�- 400- ob�.o
Contrari iM�tedness unpaiE as of Mort
sveel, cdy, state. aM ZIP code)
Nama ot assignee or othu mw+er w twlder of matgage
ALdress ot assgnee (number aM stree4 u�: state, and
Does applinnt wm propeny fn any oNer
counry in InEiana? ❑ Yes ❑ No
paf�ction app�o+ed'ui the amoum
20 _ 20
SigruN2 N CamN Autlitw
I/ We certify urMer Ihe pen:
owneJ I contrad buyyye�W
Pelson auUm�rzN Dy Cuty executed
Atltlress oi authoraed per..on (num
r�
if
Counry Auditor
A k���d�
GIBS
�b
btedness unpaid as d I Is Me appGrant Me sde
legal w equeaNe wmd+
❑ Yes ❑ No
spouse, Ifdirare wiM wtqm
Is tl�e propertY in VuesSon: M(we0y Assessed
❑ Real PmPertY ❑ ?muall�! Pssessed . . .
. ' _'_ ".v�'.;,y7 _' _ _I Fias Ih's d� Ecen �e9uested on propeity
/YIUcvR�2 ,(�RrsroP.�crz �- ❑ y� ❑
- (�A/� /�
i� — /� S
2�
— I CoumY h. daY. Y�h
�
of perjury that the above aM foregoing infortnalion is We and mrtect arM Nat the applicant is a resident of Indiana arW
pr�y2ntio�r ed property on date appysation is fiied.
?i�� �� � „� Date (monG�, daY. Yge�
sheet. crry, sla(e. aM ZIP cade)
(monlh, daY. Y��