HomeMy WebLinkAboutMortgage_Wells (2)�STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS _
� FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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� P2scnDed Uy Department ot Local Govemment Finance I� {' E3 �� ��
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INSTRUCTIONS: SEP V J L�3
To 6e filed in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: i) Real Property: During the 12 months 6efore May 11 of the year the deduction is to be e/%ctive. ���
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o(the year the deduction is to be effecbve.
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See reverse side for additional instructions and qualifications. ' GI3SON CODU i v AU�ITGR �
Applicant (owneror contract buyer- see restrictions on reverse side)
Taaing District
Assessed value of reai property as of
March 1, wrrent year
Key number / legal description
March 1, current year
If no, what is his / her exact share of interest?
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If name on record is different Ihan lhat of applicant, indicate
��me of mortgagee or contract seiler
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Address of mortgagee or wntrad seller (m
Name of assiqnee or other owner or holder
and street,
mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appticant own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amount of:
�
Signature
20
Record number
Page number
unpaid as of Is the applicant the sole legal or equitable
ownef? �-�fes ❑ No
I
If owned with someone other than spouse, indicate with whom.
state,
couNrv
20 20 �
P
County Auditor
Is the property in question:
�Real Property � Mobile Home pC 61.1-�
1 p - 75 �
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What Taxing Distrid�- �
�
Drawer ND.,B„�-.
Card �p, ..
2�S 7
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been requested on
year?0 Yes� No
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We certify under the penalty of perjury that the above and foregoing information is true and correct and ihat the applicants was / were
��sident of Indiana and owner of the aforementioned property on March 1, 20
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/ -b
Person authorized by duly executed Power of Allorney
or by IC 6-1.1-72-.07
of authorized person