HomeMy WebLinkAboutMortgage_Davis (6)�=—'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
t... _= FOR DEDUCTION FROM ASSESSED VALUATION
� " Slate Fartn 43709 (RS / 2-07)
�' y,. ' Prescribed by Depanment of Local Go�emment Finance
ie
INSTRUCTIONS:
To 6e filed in person or by mail with the CountyAuditor of the tounty wheie fhe property is located. A U � 1 4 Z �08
Fding Dafes: 7) Real Property: During the 72 months be(ore June 17 of the year the deduction is to be effecGve.
2) Mobile Homes assessed under IC 6-7.1-7: Befween January 15 a�M March 2 o(fhe year the deduction is to be effective.
See reverse side lor additional instructions and qua/i(cafions. �JJ,,,_ �,�!_
Applicant (owner or
I (�T (p — / 1
as of March 1, ament year
what is his! Fier exacl share of interest?
on
morlgagee or
]e / Contraa iMeWedneSS unpdid as of MarCh 7, s Ute applit2nl �h0 Sde legal w equit2de wmCr:
rear � 9 ��� ❑Yes ❑NO
If owned with someme W�er �han spouu,'vWicate wi�h whom.
of moM1gagee m m�Uaa seller (number and street. dty. stafe, aiM LP crotle)
Name ot assgnee or ather owner w holder of mortgage
Address ot assigrree (rnm�6er arM sVeet, city. stafe, aM ZIP code)
Dces applicant own property in a�y other If yes, wha� cwnty?
couMy in Intliana?
❑ Yes ❑ No
Deduction apprwed in ihe amaunt of:
20
Signawre
20 I 20
Is Ihe property in quesUon:
❑ Real Hoperty t O Mobile Home (IC 61.1
� ......
Drawer NO....�•
_ 8'1 ? �S
....... .......
Card NO. ••�•39, 5
y� C��q�Q sled on P�PeM
I ❑ Yes ❑ No
COUNTY AUDITOR
20 20
Caunry
20
Dffie
20
I I We cerlify under the penairy o( perjury tliat Ihe above and foregoing information is trUe and cortecl and tliat the applicants was I were a resident of
Indiana and owner of Uie aforementioned property on March i, 20 _
� / J�=
address ot applicant (number and sLeet. ci(y. state. and,ZfP code)
«ty ic �i.i-iz-.o�
Address of auttv¢ed person (number aM streel, cify. s(afe, antl
v.'flc . l � �/ 7�
Date (rtarifh, Oay, yea�
day, r�n