HomeMy WebLinkAboutMortgage_Allen�" STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION fROM ASSESSED VALUATION Coun Township Year
State Form a97os (Ra � taot) . - . ' - -
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PrewiDeO by Department ot Local Govemment Finance ,� '� �� 1
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INSTRUCTIONS: ��� lile MLUJ3
To be filed in person or by mail with fhe County Auditor ol lhe county where the property is located.
Filing Dates: 1) Real Property: Dunng the 12 months 6e%re May 11 of the year the deducfion is to b �ef/ective. � �
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and Marc6 31 0l theryear_�th d duction'is to be eHective.
See ieverse side (or additional instructions and qualifrcations. ' '-
Applicanl (owner or contrect buyer - see restrictions on reverse side)
I'YlA.rk A. a.�.d. A+ti►�., nn . R�l.t�,�
Taxing Distrid Key number / legal desuiption
n
' o�Ti�,� .
Assessed value of real property as oi
March 1, wrtent year
If no, what is his / her exact share
If name on record is diHerent than that of
of mortgagee or conlraG
�
bo%- Oo�zl-oo
Mortgage / Contrect indebtedn
March 1, curtent year
''llo, �00•OD
Kecortl number
� �✓— .��
Page number
.
as of Is the applicai
ownef�
t t e soie iegai or equnaou
Yes ❑ No
If owned with someone other lhan spouse, indicate with whom.
❑ Real
Address of mort ee or contrad seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of moAgage
Address oi assignee (numberand street, ci
Does applicant own property in any olher li
counry in Indiana?
Deduclion approved in the amount of:
20 20 20
�
I Signature
state,
O Mobile Home QC 61.1 :
what wunry? What Taxing District? Has th�s tletluction ceen reques[ea on
property for curcent year? � Yes ❑ Nc
COUNTY AUDITOR
20
County Auditor
�
20 O T 20
!
Date
I/ We certify under the penaity of perjury.lhat the above and foregoing information is true and correct and that the applicants was / were
a resident of Indiana and owner of the aforementioned property on March 1, 20
(ull name)
address
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Person authonzetl by tlury exewreo rower or H�corney
or by IC 6-1.1-12-.07 �
of authorized person