HomeMy WebLinkAboutMortgage_Ricker (2)"'�'�° STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'+,�-" � FOR DEDUCTION FROM ASSESSED VALUATION
S y State Form a37os (Ra i 7o-ot)
�� � Prescnbetl by Department of Loral Govemment Finance
INSTRUCTIONS:
To be (Ied in person or by mail with the County Auditor o! the county where the property is locard.
Filing Dates: 1) Real P�opeRy: During the 12 months be%re May 11 of the year the deduction is to be ef/MC�iv�. � 200Z
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 31 of the y�ar fhe deductwn is to be eSective.
See reverse side for additional instiuctions and qualifications.
Applicant
Taxing Disirid
Asses'sed value of real
March 1, current year
buyer- e re3tri i on reverse si� )
Y
Key number / legal description
� � �� b�5'3o -Oo
.rty as of MoAgage / Contract indebtedness unpaid as
March 1, currenl year
��D.O o C'�
no, what is his / her exact share of interest?
If name on record is different than tnat oi applicant, indicate below:
of mortgagee or coniract seller
of mortgagee or contraIX seller (number and street, city,
of assignee or olher owner or hoider of mortgage
of assignee (numberand street, ciry, state, ZIP
Does applicant own property in any other If yes, what county?
county in Indiana?
Deduction approved in the amount of:
20 Q� (.• �'i' I 20 � I 20
�
_� ;
Record number m �
�%
Page number
Is lhe applicant the sole legal or equitable
owneR ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
s the property fn queslion:
❑ Real Property ❑ Mobile Home QC 61.
/(�l/c �'/
What Taxing Dislrid? Has this dedudion been requested on
property for current year? � Yes ❑ No
COUNTY AUDITOR
20�
County Auditor
20 !� 7 I 20 _��
Date
�
certify under lhe penalty of perjury lhat the above and foregoing information is true and correct and that lhe applicants was / were
lent of Indiana and owner of lhe aforementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person