HomeMy WebLinkAboutMortgage_Overton (2)STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S�/ Siate Fortn 63709 (RS / 4-03) '
� PtesaiDed by Depanment ot Local Govemment Finance
INSTRUCTIONS: File Mark
To be filed in person or by mail with the CountyAuditor of the counry where fhe property is located. � "^ ,a, ,)
Filing Dates: 1) Real Property: Dunng the 12 months belore May 11 of the year the deduction Is.to 6e eflective.�� '�J�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o�he year.t�deduction is to be efiective.
See reverse side for additional instnictions and qual�ca[ions. � � � ��Q�
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ApplicaM n r or contracf buyer - see resMcti �ns on ievers side/), /` _� �,�'Spk 1
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Taxing Dis rid Key number / legal description Rewrd;nu`mber ��
�./��'�it'L �� D�/ O Ci���-- jC� Page number
Assessed value of real property as of Mortgage / Contred indebtedness unpaid as of Is the applicant t'sole legal or equitable
March 1, current year March 1, current year owneR ❑ Yes ❑ No
/o� (� o O
If no, what is his / her exad share of interest? If owned with someone olher lhan spouse, indicate with whom.
If name on record is different ihan that of applicanl, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home QC G1.1-n
�3me of moAgagee or contred seller / �
�� r�a./ G-. /� / L�-5
Address of mortgagee or contract selier (number and st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applipnt own property in any other If yes, what counry? What Taxing District? Has this dedudion been requested on
county in Indiana? property for current year? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 �j� 20 � 20 20 �$_ 20 O 20 20
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Signature County Auditor Date
�/ We certify under the penalty of perjury-thal lhe above and foregoing informalion is true and corred and lhat the applicants was / were
resident ot Indiana and owner of the aforementioned property on March 1, 20
Si ture (owners full na )_ Person authorized by duly executed Power oi Atlomey
` ,�-- ,LL?1�-- or by ic s-�.i-iz-.o�
'•Full�i ident address of applicant Address of authorized person
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