HomeMy WebLinkAboutMortgage_Toth (2)c.�"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'` � FOR DEDUCTION FROM ASSESSED VALUATION o T hip Year
! Stete Fam 43709 (R6/5-06)
r� Presaibed by Depanmenl of LOmI Gwemment Finance
� —
INSTRUCTIONS: � a �i�ark
To be filed in person or by mail with the County Audito� o/ the county where the p�operty is located. f° �' f"
Filing Dates: 1) Real Property: During the 12 months before ,lune 11 of the year the deduction is Eg��g��NTY AUDITOR
2) Mobiie Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is fo be effective.
See reverse side for additional inst�uc6ons and qual�cab'ons.
see
Assessed value of real property as of
March 1, curtent year
no,
name on
exact
on reverse side)
Key number / legal
�b-1?J-I 1 -1CK�-GC3.
Mortgage / Contract indebtedness
March 1, curtent year
below:
�e of mortgagee or contract seiler �/�
Address of mortgagee or conVact seller (number and street, city, state, ZIP
Name of assignee or other owner or
Does applicant own property in any
county in Indiana?
Deduction approved in the amount of:
C��7� � �
J
mortgage
�
Record number
Page number
l
mpaid as of Is the appli
owner?
someone
O�
legal or
� No
than spouse, indicate with whom.
property
� Mob7e Home QC 61.1-n
Dra���cr �O��Q•I.:.l..13�'
..., . ..... . .. ........� ..
C�I.� \�, ..; .....;.j � . ..p`
If yes, what county? What T OO J� 3/� /'�j W ed on
� ��� �OrJ / .... I � _,pNa
COUNTY AUDITOR
20 20 20
County Auditor
20
20
We certify under the penalty of perjury that the above and foregoing iniormation is true and cortect and that the applicants was / were
'sident of Indiana and owner of the aforementioned property on March 1, 20
Pature (owners full name) Person authorized by duly executed Power oi Attomey
�r„�� ��1 L� or by IC 6-1.1-12-.07
ruu resiaen[ aoaress oi appucanc Hoaress or aumonzea person
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