HomeMy WebLinkAboutMortgage_Mair"^• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION ;
s�a ram as�o9 �rta i z-0�� -
S � Presmbed M Deparlment at Loral GovemmeM Firance
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Fle Mark
lNSTRUCTIONS:
To be filed in person or by ma� wiHr the CouMyAud'rto� o/ the courtly where the p�operty is located. MAi 1� 2��9
Fding Dates: i) Real Property: Dunng Ure 12 monG�s be/ore June 17 d the year the deduction is to be eRective.
2) Mobile Homes assessed urtdei IC 6-7.1-7: Belwaen January 75 and March 2 0/ the yeai the deduc—tiyon� is to be effeclive.
see 2verse side lor adals�rta�;nsauctions anc qua�;ficafrons. d'/a-ti �/,�,
��
i � QlRll� �0if
her exad share of interest?
If ivme m recard is dilferent ihan Nat o( applicanL
Reoord num Page
�ot- .a67-o� a� �
/ inCaWetlness unptid as of March 1. Is ihe ap�cent Ihe sde legal or equitable omieri
�
��� ❑Yes ❑No
If owred with someane dher Ihari spousa, iMinte with whom.
Is Ihe ptoperty in questim:
❑ Real Prooertv ❑ MoWle Home OC fr7.1-
Name of rtqrtBeBea or cmlraG seller ( /1 `Y W-�
`i vi
nmress ot mortq�ee u mnvaa se�ler (iwmber ar�e.meet db, siate. end z�P coae)
Name of assignee a dher uvner a hdder at mortgage
Addrnss of asspnee (rcniber end shee(, aty. 9ale. and LP oode)
Does appicaN wm PropaM in a�ry olha If yes, what cwrrt�t
county in Indiaral
❑Yes ❑ No
Deduction appmved in �he amamt of:
20 I 20 2b
wre oi Camtylw�cbr
VJhatia�m�g DisUid?
COUNTYAUDROR
20 _ I 20 I 20
uested on poperty
❑ Yes ❑ No
Date (mmth. daY. YeaA
20
I/ We certify under ihe penalry of perjury Mat the above and foregoing inforrt�ation is W e and cortect and tliat the applinnts was I were a resident of
Indiana and ovmer of the atorementioned property on March 1, ZO
u�ature (amafs NI �rrel Dafe (mmfh, daY. Yean
tlem eddress of apqk
�U�I �.
Permn aWwaed by duy arzt
AtlOr�s of author¢ed parsm
�ee /"/ft �i<
(nim�ba� end streel. aty. state. and LP cd
/''Jo�fyoM�Q� S�
led Pwver oFFLLbrney w Oy IC .1-12-.07
umbei and streef. cQy, s/afe, and LP mda)
en
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