HomeMy WebLinkAboutMortgage_Jochim (4)""+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township vea
__,. , FOR DEDUCTION FROM ASSESSED VALUATION
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INSTRUCTIONS:
To be �led in persan or by mail with fhe CountyAudiror or Counry Recorder o! the counry where the property is located. F� � � ���7II�
Fifirg Dates: 7) Real Property: Must file dunrg the }rear hr which fhe detluction is sought D E 1(�unFy�nnbtliwr
2J Mobi7e /Manu(actured Homes rrot assessed as Real Property Must file dunng the tweNe (12J months
before Marcfr 37 0/ eacA year Ne deduclion rs swght ❑ County Recorder
See reverse side lol ad '' nal insWCtions aM qualificafions. � ~(p �
A°���� �l�!`°u'.`b�i"e (A /�f n_.. c3tBSON COUNYY AUDiT01�
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tt no. what is hit / her eraa
Key numCU / legal d l� "' ��� `/ `�h/ �' T�O� RecoN rwm
Mortgage/ ContraG ind�tetlr�s un0aid az W Mortgage / ConTa�'uWe6tedness unFZN as ot
Mart�h 1, wrtent � Q O� date o( aGP��
d4 l%
If rwna m recad is Eitlerent fhan Mat W appOcarK tr�d'rate Eelmr.
Name ot rrotgagee or contratl se0er
Name of az5ignee or oiha! rv'- O
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DeEuctlrn a �On ...
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20 � 20 _ � 20 � 20
mmearre aher Ihan spouse.
Whal Taritg 06bitt?
20
Page
legal w e9Nm� o�v�u(/
n Yes n No
Is Ihe property in questim: MnuaAy Avessed
❑ Real RoPenY ❑ ��Y �
Mobile Fbme (IC 67.
F1as tha deODUion been re9uested m propeity
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�o�/l�M�-� I"�-�I I �nry ��/Wd�l �`�.aaY���_IC_'�
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I�certify under th penalty of perjury at ihe above and foregoing information is we and cortect arM that Me applicant is a resident of Indiana aM
owner I contraq buyer ot the atoremerrtioned property on date appiication is filed.
�ratue (ownen NO nartre) . Date (monfi, daY. Yaa�
state,
Pelson autloristl �y dWy executed Pawer of At6xneY ��' IC Ft.t-t2-0.7
Gersan (number arrtl sbeet dN. state.
Date (monN.