HomeMy WebLinkAboutMortgage_Blankenship.r�'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS u r To ip Year
,��i� FOR DEDUCTION FROM ASSESSED VALUATION 1
Sute Fwm 43709 (R8 / 2�7)
'�; � Presaibed by Department of Local Govemment Finance
File Mark
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor o! the couMy wheie fhe property is located. � � ��
Fdin9 Dates: 7) Real Property: Dunng the 72 montfrs befwe June 11 0/ fhe year fhe deduction is to be e/lec6ve.
2) Mobile Homes assessed under IC 61.7-7: Behveen January 15 end March 2 0/ the year the dedur�c�� �e �O�iu�e.qUDITOR
See 2verse side la addifional inshuctans and quali�cations.
(owner ormnfrdcl b�yer- see reshi�jians on revarse
0
3 Dislnd � Key num6er I legal tlescriplion / Reoortl number Page number
a 6 - � - -ivo _ o00 , � _ � aoo � 93 S
sed e af real po as aF March 7, aarent year Morlgage / ConUad indebtedness unpaid as of March 1, Is Ihe app6c2nt Ihe sde legal d equitade ame(7
aneM year
S�QQ� ❑Yes ❑No
whai is his / her euG share of iirieresl? If amed wilh someane dher than spouse, indicale with whom.
If name m recwd is d'rfferent Ihan that
Address of mortgagee m m�Uacl seller (number aM shee(, tity, sb(e.
Name of assigrree a oU�er owner or hdder of mortgega
Address of assgnee (number aM streef,
Does aPW�nt wm propeM in any oUer If yes, whel caunry) Whal
courrty in Ind'ana?
❑Yes ❑ No
Deduction apprwed in the amwnt
�
SignaWre of CounryAutlibr
COUNTYAUDITOR
24_ � 20— � p—
Counry
�
Is Ihe propeM1y in question:
❑ Real PropeM ❑ Mobile Home (IC 61.1
�co� -9 3g 1
a- �3-0'1
� 50i C�0 . e° � o� ,�.
L•SgQ �+, Q_ � es ❑No
.aua.lQ tJcINC
20
20 _
1 I We certify under the penally of perjury U�at fhe above and foregoing infortnation is true and mrtect and fhat tlie applifants was I were a resident of
�dia nd owner oi the afwemenfioned property on March 7, 20
e (owne/s lull namel D� (^b^�. �y.Y�A
Fu0 2sidenl addrms of applicarK (n
$/orw S.s� S
Person aufhonzed Dy duy exeated
of aulhw¢ed persan
i street. cify. sfe(e. �aML�P wde)
vTSliwn _/V 4� �
Attomey or by Ic G7.1-1z-.o7
-�
Z/P oo0e)
oae �mon�r. aay.