HomeMy WebLinkAboutMortgage_Rice�'�'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
- t FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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,� Prescribed by Depanment ot Local Govemment Finance N p
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INSTRUCTIONS: �AK �. % 2OO�le Mark
To 6e filed in person or by mail with fhe County Auditor o/ the county where the property is located.
Filing Dates: 1) Real PropeRy: During the 12 months before May 11 of the year the deductrnn is to be el�ect'w.�e. !//�
2) Mobile Homes assessed under IC 6-1.1-7: Befween January 15 and Marchu3�f-of,tpe e�r,tir��d6tfioiris� 6e e/%ctive.
-� ,;ioc�;�Y:',��•�-•• 1LDITOR .
See reverse side (oradditronal instructions and quali�ca6ons.
Applicanti,(owneror contract buyer- se�stnctiqa, on reverse s )
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Tacing Distrid Key number / legal descriplion Record number
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Page number
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Assessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtenl year March 1, current year owner? ❑ Yes ❑ No
Q��
If no, what is his / her exacl share of interesl? If owned with someone other than spouse, indicate with whom.
If name on record is different than that of appticant, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home pC 6�1.1-�
�me of moAgagee or conVad seiler /�
Address of mortgagee or wnVad seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (numberand street, ciry, 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? propeAy for curtent yeaRO Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
za �,� zo zo 20 0 zo 0 zo �_ zo 0 9
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SignaWre County Audifor Date
/ We certify under the penalry of perjury that the above and foregoing information is true and corred and that the applicants was ! were
resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (ownels full name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full resident address of applicant Address of authorized person