HomeMy WebLinkAboutMortgage_Veit^�� STATEMENT OF MORTGAGE OR CONTRACT INDE��� oun Township Year
__ • FOR DEDUCTION FROM ASSESSED VALUATION
(�. �• StateFOrtn43709(R11l609) JUL 1 6 201
� ! p�y�ip� py pe��nt of Loral Govemment Finance
�"'� C ,� File Mark
STRUCTIONS: F� �� �:
To be filed in person w by mail with the CouniyAuditor or County Recwde� o/ the couniy where the properry ted �/
Fiimg Dates: 7) Real Property: Must file dunng the year for which the deduction isQ{g�pN COU NTY AU K � Counry Auditor
2) Mobile / Manufactured Homes rrot assessed as Real Praperty Must file dunng the hveNe (12) months
before March 31 of each year the deduction is sought Counry Recorder
See 2verse side for addiliqn�l instructions arM qualifra[io�s. ,
/legal
�C9a9e / Contraa "ude6tedness unPaiA
MarM 1. artrenl �"1c� i��in
her e�r] share ot interesl?
on rearE's 6Rr�ent Man Nat o( aDpliranL
Name M mM4a9ee
� Address of
pl•a���cr �O
_�
�-- �
��.-/ \ .� . . . . .
aM ZlP coda)
�0....3�5`�........ ���M
Card
I ��'��\,� J
C�U
Deduction appioved In the artauni of.
Zp 2p _ 20 20
I I We certrfy under the penalry of perj(�!y that the above
rnrmwr l mntrart buver of Ne aforementioned woDertY a
Puson au0roraed Dy EWy exeate0 Power W Actorney
as o( Is Ne app6rant Me sole
legal or epuitade oxnel.�
❑ Yes ❑ No
someorie othu Ihan spouse. i�icate wM Mmm
NRat Ta�dng D'¢IriG7
20
I5 ihe ProPertY in VueSUm: MnuallY Assessed
❑ Real ProPeKY � !�^�!�1:�
de�udion Eeen requested m p�oputy
„rean ❑ ves ❑ �
20_ 20_
oate (monrh. day,lg'() i�. / /
�egoing infortnalirn is we end correa arM that ihe applirant is a resident of Indiana aM
application is filed.
slate. end ZIP ootle)
authnrzed person (number a� stree4 �: sfate, and ZIP code)
�Y.Y��
oate (monlh, eaY. v��