HomeMy WebLinkAboutMortgage_Wilson'°� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ship Year
_ + FOR DEDUCTION FROM ASSESSED VALUATION � � v--
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To 6e filed in person w 6y mad with the Counry Auditw or Counry Recorder of fhe counry whela the property is located.
Filing Dates: i) Real Pmperty Must file Curirg the }rear fir which Na deductlon is sought � County Auditnr
2� Mo6de / Manufactured Homes rrof assessed as Real Property Musf fi7e dunng the hvelve (12�/�rN�, �
6efora March 31 0! each year the deduclion is soughf. ,�/ "' �" it ❑ Counry Remrder
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See reverse side !or addttional instructions and qualifications �;1BSpN CGUNT �
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� qopu;y at ot MMortgage�� indebted� unPa� az N MMgagae � hMebtedness �mP� aa d i
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rc ro, what Lv his � ner e�cc stwe or inte�est?
I( name m �emd'e E'iffemnt Nan tlat of aPp�ant,
Name ot rtartgagee ar cmtrsa sWer
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Mdres of nnrtgaga or cantraG se�a (nun6e� a�
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straeG �'dY. sbte. an0 LP code)
or �aer rn nartgage
Adaress of a�gnee (numDa� eM stree; r4y, stete, aM
Ooes ePpli�m oxn property in a(ry oNer
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� O�GQrtY in VuesGm: Mm�aDy Asusud
}Real ProPertY ❑ ?,nnual�Y'4ssessed
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I I We certify urWer Ne penalry ot pe�jury that the above a`W faregoing intwmalion is true and cortect arM ihat the applirdnt is a residertt of Irdiana aM
owner I mntracl huyer of the aforementioned pmperty on date appfication is filed.
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Address of eutha'ved v� (numbe�ard stee4 aN• ��e. end LP mde)
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