HomeMy WebLinkAboutMortgage_Vaughn^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T Year
�_ FOR DEDUCTION FROM ASSESSED VALUATION
� smca Fam a3�as �rtii i s-os�
� 1 PresmDed by �epenrt�ertl ot Lod GovemmeM Finance
File Mark
INSTRUCTIONS: � �m
To be filed in person a by mail wiM the County Auditor or Cowry Recorder o/ the wunty whem the property is located.
Filirg Dafes: 1J Real Pmperty: Must fife durirrg the year lo� which the deducfion is sough[ a�� q�ditor
2) Mo6de / Manufadured Homes rwt assessed as Real Property Must file dunng the hveHe (72J months � 6
be(ore March 37 ot eacA year the deduction is sought. Re�rder
v
See reverse side /or addifional insVUClbns and qualifications. ,_ GIBSO
Appf (ouirer qconf2d buyer - see reshicna�ns m reverse siCe) . J
tl naznC on �Eaxtl a NftPf¢nt Nan
Name oi �ee «c trar3 v
nearess ot nwrtqaqee «cono-aa
Name of assignee w oNer owner
imber / legal desaiof
-//- /� �
and saeet cay. uere.
. oo/. /3�- � a 7
dness unpaid as ot Mortgage / Convaa m
d3I8 Of 2DG�C2t1011
AEde¢SS O7 05519nC2 (nUmb2/ eM Stree; tby, siat@, antl LP ootle)
Ooes epplipnt o.m yoperty in any oNn If yes, what muntyT
munry in InC"ana? � Yes ❑ No
COUI
Detluctian appfoved'o� the amount ot
2p 2p _ 2p _ 20
SioriaNeBUCOUnNAudifOr � /
I I We certfy yJ(der ihe penatty of
owner I con4�ct buyer of ihe afon
Person auNOr'¢etl W duh/ ex2ated Pwmr
AtlCress o1 auUmrvetl person
0o y 5 a7
unpai0 as of Is Ne appfrcant Ne sak
legal u epuitaNe owne(?
❑ Yes ❑ No
If awned v.iN someane other �han 5pouse. IMicate with wlrom
perty in Quesom: Mnua%PSSesseE
RoPerty ❑M^uallYPssessed
Dra«•cr \'0.:.:�QQ� —
4Ma� Taong �
Card NO.�:..'':;:y�.r.�. °Zr] �
......
No
�Jd�#ariY rf) . Va,lQ��fQ'V�" —
\LIDROR �"` ��'�' 1�0�.� • " —
p— � p—
(monfh. daY. Y��
20 _
the above and foregoing infortnalion is W e and correct arM that Me appfuant is a resident of Iridiana and
property on date applicabon is filed.
rn Cy IG 61. f 42-0.�
stale, an0 LP code)
Date (rtronN, daY. Y��)