HomeMy WebLinkAboutMortgage_StroudSTATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
�. �M ! State Fwm 43709 (RS / 4-03) _ __..1 -'s -p- �'�`� �
Prescribed by Department of Local Govemment Finanm �� ...� ti �� ��
� jl Fi i
iNSrRUCnoNS: APR 19 aQJ�ark
To be filed in person or 6y mail with the County Auditor of the county where the property is located� �
Filing Dates: 1 J Real Property: During fhe 12 months before May 11 of the year the deduction is�to be eHective. '�' ///�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 ollhe-year_t�eduction'isli$e�ffective.
See reverse side for additional instructions and qualifications.
,� GlacpN t';CUN71' Alvi7G. �
Applicant
Taxing Distrid
March 1, current year
side)
number / legal description
Od S- b 3 S 7S -o�
property a Mortgage / Contrect indebtedness unpaid as �
March 1, wrrent year
Ii no, whal is his / her exact share of
If name on record is different than that of applicant, indicate
of mortgagee or contreIX seller �
number `
lJ
Page number a S � �
` Is the applicant the sole legal or equitable
owne(? ❑ Yes ❑ No
Ii owned with someone other than spouse, indicate with whom.
Address of mortgagee or contrad selier (number and�st2ef, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and sGeet, city, state, ZIP code)
�
Does applipnt own propeity in any other If yes, what county? I What Taxing Distrid?
county in Indiana?
NTY AUDITOR
Deduction apF Drawer NO. �.�.-..�5/ `�
....
.
,�.. ,:. ..
20 -�� Card NO . ......:.............. 2 Zo�L
� � _... : , � �
Signature �
County Auditor
s the property in question:
❑ Reai Property ❑ Mobile Home (IC 61.1-�
Has this dedudion been requested on
property for current yea(? Q Yes ❑ No
zo � zo
�
Date
/ We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicants was / were
resident of Ind�na and owner of the aforementioned propeRy on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-t.t-12-.07
of authorized person