HomeMy WebLinkAboutMortgage_Streicher�'� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S j stale Form a37os (Ra � �o-o�)
w.
� Prescribed by Department of Loral Govemment Finance ,
INSTRUCTIONS: � .File Mark
To be filed in person or by mail with the County Auditor ol the county where the property is located � t; �i! ��j'�y
Filing Dates: 1) Real Property: During the 12 months be%2 May 11 0l the year the deduction is to 6e effective. J,�J � �/
2) Mobile Homes assessed under IC 61.1-7: Between January 15 and March 31 of the year th`e ded�tion is to e e e�e.
See reverse side (or additional instructions and qualifica6ons_ � � iV � U 2QQ3
(ownerorcontract
Taxm nd
�v �
r.
Assessed value of real property as of
March i, wrrent year
what is his / her exad share of interesl?
Y AUDITOR
Key number / legal description ' R'ecord number O�
O Q� � Q/{y� /�,— 0� Page number ( j�� �
!Te 7
MoAgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, wrtent year , owneR ❑ Yes ❑ No
.300 �
If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of applicant, indicate below:
�me ot mortgagee or contract seller
��
Address of mortgagee or contrad seller (number and street, city s
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and stieet, city, state, ZIP code)
Does applicant own property in any
county in Indiana?
If yes, what county?
Deduction approved in the amount of:
20 20 ��� 20
Signature
�
ZIP
What Taxing Distrid?
COUNTY AUDITOR
20
County Auddor
r� � -
s the property in question:
❑ Real Property ❑ Mobile Home (IC Fr1.1-�
Has this deduction been requested on
property for current year? � Yes � No
20 �_ 20
P
Date
I We certify under lhe penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
tesident of Indiana and owner of lhe aforemenlioned property on Marrh 1, 20
(owne/s full
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person