HomeMy WebLinkAboutMortgage_Hollis�� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS �
FOR DEDUCTION FROM ASSESSED VALUATION Co n, 7o hi _ Year
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INSTRUCTIONS: 6� '�
'6File-FAark
To be filed in person or 6y mail with the CountyAuditor ol the county where the propeRy is IocatQ1B50N COUNTY AUDITOR
Filing Dates: 1) Real Property: During fhe 12 months before May 11 0( the year the deduction is to 6e eflective.
2J Mobile Homes assessed under IC 6-7.1-7: Between January 15 and March 2 0/ the year the deduction is to be effective.
See reverse side /or additional instructions and qualifications.
Applicant
Taxing
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reverse side)
number ) legal
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Record
Page number
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Assessed value oi real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitabie
March 1, wrrent year March 1, current year ownef? ❑ Yes ❑ No
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If no, what is his / her exac[ share of interest?
If owned with someone olher than spouse, indicate with whom.
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If name on record is dif(erent than that of applicanl, indicate below:
�me of moAgagee or contract selle ,
Address of mortgagee or contrad seller (n er and street, city, state, ZIP
Name of assignee or olher owner or holder of mortgage
Address of assignee (numberand st2et, city, state, ZIP code)
Does appliwnt own property in any other If yes, what counry? What Taxing
county in Indiana?
Deduction approved in the amount of:
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P
SignaWre
COUNTY AUDITOR
20 O� 20 20
,�,
County Auditor
Is the property in question:
❑ Real Properly p Mobile Home QC 61.1
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requestea on
property for current year? � Yes ❑ No
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20
certify under the penalty of perjury that the above and foregoing information is true and corred and lhat lhe applicants was / were
lent of Indiana and owner of the aforementioned propeRy on March 1, 20
Signature
resident addre
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icant
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Person authorized by duly executed Power of Attomey
or by IC 6-7.1-12-.07
of authorized person