HomeMy WebLinkAboutMortgage_Jones (4).P °'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
- ' Slate Farm 43709 (R8 / 2-07)
�' �� Presrnbed by Department of Loral Gavemmenl Firance '
INSTRUC710NS: '
To be filed in person or by mad wdh the CountyAuditor o7 the courrty whera the pmperfy is located.
Fding Dates: 1) Real Property: Dunng the 12 monfhs be7ore June 11 0/ the year the deduction is to 6e eRective.����/ ���, ZQ�'�
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and Ma2h 2 o/the year the dedVtlHdn is to be eAecGve.
See reverse side fa ad�tional insWCtions and qualifications.
� `�'l% �.. ,a�
Applicant (owner Irad 6vyer - see resLictjoy m re�er�e side) � _...�.. � � �nITOR
n/b'I`1-Id'.�St)St OE
w��oi��r�mr.+��a, i.�
I�'at is his / her ezad share of inle(esl?
If iwne m remrd is differenl �han ihal af appl
Name of rnorigagee or canUacl seller
� _�« .
y�r Mw�gage / ConVap indebledness unpaid as of Marcli 1. Is 1he appucant the
artemyear „
m �onVad seller (nurnber aM sVeef. dty, state, and
af assigriee or otha awner or hdder of mortgage
Address of assgnee (num6eian0 sVeeG
Does applicant own poperty in arry aner
caunly in Indiana7
❑Yes ❑ No
Deduction approved in Ne amwnl af:
r:u
sigrawre ot Caunry Autlnor
m
IF owned with someone olher Ihan spouu, indicale vn�h
-�' �.wnatTa�tlng Dis
�a�C,S ('E-�,�� `'
��f�{ y 1�
��� a�3�JS
�
is u,e a�m
❑ Real Pmp
d equtade wmeR
❑Yes ❑No
❑ Mobile Home pC G1.1-7)
Has Uus deduclian beeri requested on proper�y
fa wrrenl yea(?
❑ Yes ❑ No
Zo _ i Zo _
yea�
I/ We certify under the penaity of perjury that ihe above and foregoing in(om�ation is W e and mrtect and tlial fhe applipnfs was / were a residenl of
Indiana and owner of ihe afwementioned propeAy on March 1, 20
�.,��r/A�.,.�e�.. nar „�..,oi _ n Dale (mmN, day, yea�
address
Pason aulhor¢ed
and sbeeL cdv. stafe.
d by IC 61.1-02-.07
person (number and sLee( aty, s(a(e. arM LP
Oate (mmfh, day, yea�