HomeMy WebLinkAboutMortgage_Higginbotham"^� �ATEMENT OF MORTGAGE OR CONTRACT IN T n Township Year y
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FOR DEDUCTION FROM ASSESSED VALUATIO� �
� • State Fwm 93709 (R71 / 6-09)
S ur ` Presoibed by �ePartmerd of Local GovemmeN Finance
INSTRUCTIONS: ,JUL S 2011 File Mark
To be filed in FO� �� ���
person w by mail with fAe CounryAUditor or Counry Recorder of the county whem (he io is located.
Filirg Dates: i) Real Property: Must file during Ihe year for which the deduction is wught C. J. ^ �
2) Mo6Ae / ManulaUured Homes irot assessed as Real P � W V',ry �d��
roperty: Must fiie dunng the hve 2 nths
6e/ore March 31 of each year the deductnon is sought. ❑ �^b R�b�
SeereversesideJeradddior�Tslructionsandaualificafior� G�B�+ONCOUNTYAUDITOR ^
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RemN ' I I Fage
AneSseQ r�e of propeny at artgage nVari m ness unpai as o ortgage I Con:ract'uWebiedness unpaid as d Is Ihe app�n� the sole
Ma�d� 1. da�mt Mart�h 1. date o( appfication legal w equitade owrre(.+
❑ Yes ❑ No
If m. what I5 his! her exact shara af inteir.,t? If owxred with someane oiher than spouse. mdxate wiN whom
It rame m remd is dAferent Nan Nat of appGcant, 4Mifate bebvr. I5 tl�e property in puesGOn: MmlaDy Assessed
❑ Rral Property � /vmually Assessed
i n�oeae rro� nc ��.� ;
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Address of mutga9ce w oonbsd seLer (�
Name o( assi�ee w ahu owner or hald�
Address of assignce (numberaM streef,
Does aPd�N own WoDeM in ary Ww
munry in IMana? I-1 .,' _ �
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ray, stare, end Z/P code)
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._ ��e pena�ry oi perjury that the above arM
_.._, � ppjpQ3IIye�r of Ne �ierewgntiq�d prpperty on da
Person aufMmed Oy CWy executetl Power ol AvaneY a M IC 61.1-12�.7
Pdtlress d aWromed person (numberaritl sbcet, ciry. state, and LP mtle)
W�3t Ta�dtg DistriGt?
20 _
Caunry
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mquestetl m pmpeny
��e ��. �Y ,�n
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mfortnatim is We and carect and that Ne applit�ant is a resident of Irdiana aM
ron ts filed.
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