HomeMy WebLinkAboutMortgage_Folsom (4)�� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
i' = FOR DEDUCTION FROM ASSESSED VALUATION Coun T i Year
'':-M / StateFwmd3709(R615-OG)
��.Presvibed by Deparlmenl of Local Gwemment Finance
APR 1 3 2007
INSTRUCTIONS: File Marfc
To be filed in person or by mail with the County Auditor of the county whe�e fhe propeRy is located. �
Filing Dates: 1) Real Property: During the 12 months belore June 11 of the yea� the deducfion is to 6e effecti a+�
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the yea�r��g�� (/�p'q tA�BI§�ctive.
See reverse side for additional insfruc6ons and qual�cations.
or contract buyer - see restrictions on reve�se side)
��t �!2'�"�-
Assessed value of real property as of
March 1, current year
Key number! legal description
� 6 -� � - dY-ao�( -0lX�, 983
Mortgage / ConUact indebtedness ur
March 1, current year O
3,�0
Record number
aov7
Page number
�.3� 9
as of
pOc�
Is the applicant the sole legal or
owner? � Yes � No
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
It name on record is difterent than that of applicant, indicate below: Is the property in question:
� Real Properly � Moa1e Home QC G1.1-�
e of mortgagee or contract selle
� /��� �a�- �'J�-�
Address of mortgagee or conVact seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
(number and street, city, state, ZIP code)
appliqnt ovm property in any other I If yes, what county? I What Taxing Districl
y in Indiana?
20 07
amount of:
� �i.
COUNTY AUDITOR
20� 20 20
� Counry Auditor �
�0o7-23i��--- —a�
� �� �o
�'� �l'i'� j� ,y�o.
� �\I'
�
20
Date
20
We certiTy under the penalry of perjury that the above and foregoing infortnation is true and cortect and that the appticanLS was / were
1+sident of Indiana and owner of the aforementioned property on March 1, 20
or by IC 6-1.1-12-.07
es�ioenc aaaress o� appncam v,aaress o� aumonzea person
�7 � a 5. ii� GLI�, /.� �,� f3