HomeMy WebLinkAboutMortgage_Thompson (8),�.
STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun�1 Township Year
�i' .. State Fortr. a3709 (RS I a-03) g
� P2saiDed Oy Department of Local GovemmeN Finarxe ���
INSTRUCTIONS: OCT O � ZOOS
File Mark
To be filed in person or by mail wifh the County Auditor of the county where the property is located.
Frling Dates.: 1) Real PropeRy: During fhe 12 months befo2 May 11 0/ the year the deduction is to be�flectivB:Qd
2) Mo6ile Homes assessed under IC 6-L 1-7: Between January 15 and March 2 o/�e���� �i��dN��A��c�e eflective.
See reverse side for additional instructions and qualifications.
o� contract buyer
Taxing Distrid( /
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Assessed.value of real property as of
March 1,-curcent year
If no, what is his / her exact share of interest?
If name on record is different than that ot
of mortgagee or contraU seller
GTiI
Key number % legal description �
o� `%- �9 y��'--� `
number
number
O d
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MoRgage / Contract indebtedness unpaid as of Is the appliqnt the sole legal or equitable
March 1, current year ownef? ❑ Yes ❑ No
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f owned with someone other than spouse, indicate with whom.
indicate below:
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Address of mortgagee'or contract seller (number and street, city, state,
Name of assignee or other owner or holder of mortgage
of assignee (number and st2et, city, state, ZIP code)
Does applicanf own property in any other I If yes, what county? What Taxing District?
county in Indiana?
OMnSO � `k COUNTY AUDITOR
Dedur � \ f ` C �
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Zo _ �t�i � � - zo zo
Signature
County Auditor
s the property in question:
❑ Real Property ❑ Mohile Home QC 51.1
Has this deduction been requested on
property for wrrent year? ❑ Yes 0 No
zo
Date
zo
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 Indiana and owner of the aforementioned property on March 1, 20
name)
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
applicant �Address of authorized person