HomeMy WebLinkAboutMortgage_Wagner (2)�
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STATEMENT OF MORTGAGE OR CONTRACT INDI
FOR DEDUCTION FROM ASSESSED VALUATION
state Form a37o8 (RS � a-0a)
Prescnbed 6y Depanmeni ot Laal Grivemmem Finance
To beRU � IION rson or by mail wiih the County Auditor of the county where the propeRy is located. �� File� �
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Filing Dates: 1) Real Property: Dunng the 12 months be%re May 11 0/ the year the deduction is to 6e efle t{'�g. �7n(�
2J Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and March 2 0l the year t�rdAd�hon43'l646e effective.
See reverse side for additional instructions and qualifications.
Tv n�l01TOR
Applicant (owne� contract buyer - sq� restncti ns 2verse side)
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Taxing Distrid Key numbe / legal description Record number
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Q //_U��/ _ QD Page number
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, current year owner? ❑ Yes ❑ No
00 00 � �
If no, what is his / her exact share of interest? Ii owned wilh someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the property in question:
❑ Real Property ❑ Modle Home (IC 61.1-�
�e of moRgagee or contrad selier
Address of mortgagee or conlract seller (number st2et, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing District? Has this deduction been requested on
county in Indiana? property for current year?� YesO No
� COUNTY AUDITOR
Deduction approved in the amount of:
20 D(� 20 20 Q$_ 20 �� 20 20 20
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Signature County Auditor Date
' We certify under the penalty of perjury that the above and foregoing information is true and corred and thal lhe applicants was ! were
sident of Indiana and owner of the aforementioned property on March 1, 20
Signa (owners (ull name) Person authorized by duty executed Power of Attomey
� , or by IC 6-1.1-12-.07
uli residenl address of appli t Address of authorized person
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