HomeMy WebLinkAboutMortgage_Sensmeier"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS To p Year
FOR DEDUCTION FROM ASSESSED VALUATION
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S � Pmsaibed by �ePartrtreM at ln�al GovemmeM Finance
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To 6e filed in person w by mail with the CounryAWitor or Counry Recorder of Ne cnunty where the pioperty is located.
Filing Dates: 1 J Real Property: Musf file dunng Ne year for which the tleducfion is sougAt n Auditor
2) Mobde /Manu/actured Homes rwt assessed as Real Property Must h7e dunng the fweHe (72) moriths �' a ry
6efOre March 31 o(each year the deduc0on is saght. � ry Recorder
See reverse side !or additiona/ inshuctions arM aual�'icatior� D IBSON
AssrsseE rWue c( real prtperty as W
MazCh 1, tl+rel� year
n�.,�«�,���o,��
tl �ume on reoord's Qftfe�mt than that ot aPW
Name M nartgagee a mntract sNler
�I� �Ii V WO� � OO D' ��� �,f�l Reco O/O Pa9e number
aa
Mortgage / Contract indehtedr�s unpaid as of Mortgage I ContraG mAebteEnnss unpaid az d Is ihe app(imnl Me sok
Mar�.tartent yeer Cate o( appfmatirn kgal a equdade ameY.�
�� n , �cm� ❑ Y� ❑ No
mmea�e aher than spouse,
ACdres of rtartgagce w mnVacl seAer (nwribei aM s0ee4 �:
Name W asvgnee w oihu owner or hdder af rt��xtgage
Mtlress ot assignre (numher enE sneef, ary, sta�, eM LP cod
Oces ePplinnt rnm propercy in any oNer
countvmintliana? .—, �
DaEucCOn appm�ed N the amount ot
zo_ �_
Sig�anne otCoimyAWitor
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Card i\'O. ......J�..��.......
*�'`� � 90, Ooo.d'
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Is Cie P�GenY in Questbn: MnueAy Asse55ed
� Real PNPeKY ❑ H!?�!!�Y �
Has N6 tletluGion been
forcunentyeaR
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I 1 W rt'rfy under the penalty of perjury Nat the ahove arW foregoing infortnation is We and mrtec[ and that Me applinnt is a resident of IMiana arM
r I contract b�yYu of ihe aforeme�tioned prRperty on date appiication is filed.
i ra (ownefs 1. . 1 �A— ✓1�� A Date (nnnCi, daY. Yea�
Pe�..on autlometl
�
persan (number aiM sbee; tiry. stdfe, and LP code)
_ I Date (monfh, tlal: Yea� _ —