HomeMy WebLinkAboutMortgage_Wade, R..,
/e`�� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�!!���' FOR DEDUCTION FROM ASSESSED VALUATION 7 i Year
.�
SUte Fwm 43709 (R6 / 5-06) ' �
� Presmbed by Depanment of L«al Gwemment Finance
AUG 0 8 2007
INSTRUCTIONS: File Mark
To be tiled in person o� by mail with the County Auditor ot the county whe�e the property is located. �pr�„�
Filing Dates: 1) Real Property: Dunng the 12 months before ,lune �7 0/ the yea� the deduction is fo be elfectfve. ���'
2J Mobile Homes assessed under lC 6-1.1-7: Between January 15 and March 2 0/ the yeG18�BdN8NrT1§ �T�ctive.
See reverse side fo� additional instructions and qualifrcations.
Applicant (owner or contract buyer - s e resfncfions on reverse side)
� � wQ�
Taxing Distrid Key number / legal descriplion Record number � OQ �
��o-/)-/]-/Ol��00/,856-Od/Pagenumber ��S �
Assess alue of real roperiy as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
AM1azch 1, current year March 1, cunent year ' ownef� ❑ Yes ❑ No
�7�OOU
If no, what is his / her exad share of interesl? If owned with someone other ihan spouse, indicate with whom.
If name on record is difterent lhan that of applicant, indicate below: Is the property in question:
.. .�" " _ . . '-' •,__� o,,,,�,� .❑ Mobile Home pC 61 J-�
•me f moRgagee or contract seller ��p 7- S3 � z
AdNess of gagee or conVact seller (nu�d stieet, city, state, ZIP 'P�w �
���
Name of assignee or other owner or holder of mortgage �'�_• �� � p �i �
�.fn� !3/S o2%!J���.00
Address of assignee (number and stieet, city, state, ZIP code)
Does applipnt own property in any other If yes, what county? What Taxing District? Has this dedudion been requested on
county in Indiana? property for wrrent yeaf? � Yes ❑ No
COUNTY AUDITOR
Deduction approved in lhe amount of:
20 �f[ 20 � 20 20 20 20 20
/ �
Signature County Auditor Date
'� We certify under the penalty of perjury lhat the above and foregoing information is We and corred and lhat the applicants was / were
esident of Indiana and owner of the atorementioned property on March 1, 20
Signat e(owne/s Iull name) Person authorized by duly executed Power of Attomey
� � or by IC 6-1.1-12-.07
II resident a ss of applicant Address of authorized person
)1�5/ c.�l 5T20 /6S ou��,�s�,:,,� ��k��.GS