HomeMy WebLinkAboutMortgage_Hillard� i� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Year
��i', State Farm 43709 (R6/5-06)
� Presaibetl by Departmenl of Lool Gwemment Finance
JUL 1 2 2007
INSTRUCTIONS: • File Mark
To be filed in person o� by mail wrth the County Audito� of the county where the propeRy is located. �7% �
Filing Dates: 1) Real Property: Dunng the 12 months befo2 �une I7 0/ the year the deducGon is fo be eH�tiJe� �'
2) Mobi/e Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the p�g�61 �Ubfib'h lSll��b��flective.
See reverse side for additional instructions and qualifications.
con�uyer�e
Taxing Dislrid
�,� . )���"-�-�
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of interest?
on reverse
Key number / legal description I Record number �0 -�
�6 /S'-/P'.30�j -U Ov�9,s-D„2Z(, Pagenumber �� g�
Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitabie
March 1, curcent year owner? ❑ Yes ❑ No
/3�� 9Gb�
If name on record is dif(erent than that of applicant,
of mortgagee or contrad seiler
�I i'
below:
If owned with someone other than spouse, indicate with whom.
of mortgagee or contraIX seller (number and street, city, state;
or assignee or otner owner or noiaer ot mortgage
oi assignee (numDer anrl street, city, state, ZIP
� �77-' { p65
property in question:
❑ Real Property ❑ Mod7e Home QC 61.1-�
�
Does applipnt own property in any other I If yes, what county? What Taxing Oistri
counry in Indiana?
approved in the amount of:
20� 20 UI
r Y
COUNTY AUDITOR
20 20 20
County Auditor
��
- ��_
Drawcr i\'Oo�(�'� .. /./ .�
(o
Card 1\`O.
�.0 �3 _ �/3� .. 9�.� Go
� Propenr .... ' _
20
Dale
20
We certify under the penalty of perjury that the above and foregoing infortnation is true and corred and that the applicants was / were
esident of Indiana and owner of the aforementioned property on March t, 20
Nners (ull na e)
�
address of appli "t
rJ I p � l�--v,r
Person aulhorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
authorized person