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HomeMy WebLinkAboutMortgage_Linneweber<<Y�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS FOR DEDUCTION FROM ASSESSED VALUATION Count Township Year �j, S�ate Fwm 43709 (R6l 5-06) � Presaibed by Department of Local Govemment Finance � INSTRUCTIONS: File Mark To be filed in pe�son or by mail with the County Auditor o/ the county where the propeRy is locat�B 1 5 ZQ�� Filing Dates: 1) Real Property: During the 12 months 6e%ie ,lune Il ol the year the deduction is to be effective. 2J Mobile Homes assessed unde� IC 6-1.1 J: Between January 15 and March 2 0l the�aeChlh�6on is to be effective. �/•���V See �everse side for additional instrucUons and qualifications. G�gSON COUNTY AUOITOR Applicant (owneior buyer- see restriction reverse side) • Tauing Distrid Key number! legal description Record number -3 a-�o ��� 'fl Page number � ^ 8 � Assessed value of rea property as of MoRgage / Contrad indebtedness unpaid as of Is the applipnt the sole legal or equitable March 1, current year March 1, current year owneR ❑ Yes ❑ No 50 � If no, what is his / her exact share of interest?__ If owned with someone other than spouse, indicate with whom. ----_ If name on record is different than that ; property in queslion: aV V�- �p ! / 2ea1 Properly ❑ Mobile Home (IC 61.1-� e of mortgagee or contrad seller '� - Address of mortgagee or conVad sell� � ; �� � � Name of assignee or other owner or h • Address of assignee (number and str: � ; Does a lipnt own ro e R pp p p rty in any o '�� p�'�' Has this dedudion been requested on counfy in Indiana? property for wrrent yea(? � Yes O No �/� � ���- "G, GGU, o a Deduction approved in the amount of: — --- -- _ 20 �S 20 � 20 20 20 20 20 � � Signature County Audilor Date e certify under the penalry of perjury that the above and foregoing infortnation is lrue and corred and that the applicants was / were sident of Indiana and owner of ihe aforementioned property on March 1, 20 Si at re (owne 1 name) Person authorized by duly executed Power of Attomey � or by IC 6-1.1-12-.07 Ful esident address of appli nt Address of authorized person ot�� !>F ����1