HomeMy WebLinkAboutMortgage_Baggertt�:��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION n T hi Year
«. / SYale Fam 43709 (RB / SO6)
� Prestrihetl Dy Department ol Laal Gwemment Finance
INSTRUCTIONS: `'7-„� ��Mark
To be (led in person or by mail with the County Audito� of the county where the propeRy is located. ���
Filing Dates: 1J Rea/ Property: During the 12 months before June 17 0/ the year lhe deduction is �1�8��Q�1TY AUDITOR
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of the year the deduction is to be eliective.
See reverse side lor additional instnictions and quali�cations.
(owner or contrecf buyer - see
Asseased Valus olrealptoperty as of
March 1, arrenl year
If no, what is his / her ¢Yad
on reverse
Key nihntier / legal description Record number � O�
�_p(,./7y ouo-000.
y��_O f 7 Page number `� �/
lp
MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or
March 1, curtenl year owneR ❑ Yes' � No
�!$.ObO
If owned wilh someone other than spouse, indicate with whom.
If name on recad is �ent than that ot applicant, indicate below:
�me of mortpagae or eonVe Iler
Addresa of morteapee or contract s er (number and street, city, state, ZIP
Is lhe property in question:
❑ Real Property ❑ Mobile Home QC 6�1.
Name oi asfignee a.dher owner or holder of mortgage -
Dra�r•er 1VO.a�QG . /7G�
........
Address of aeNpnee (number and sheet, city, sfate, ZIP code)
Card NO.
....
..............
Does appC�caM am property In any other If yes, what county? What Ta ��- G p od �f� �ested on
county in Indiana? � �' Yes❑ No
COUNTY AUDITOR
Deduction apprwed in the amount
20
Signature
20
20 20 20
County Auditor
20
20
We certity undet the penalty of perjury that fhe above and foregoing information is true and correq and that the applicants was / were
�esident of Ir��wner of the aforemenlioned property on March 1, 20
Person authorized by duly exewted Power of Attomey
or by IC 6-1.1-12-.07
SWent a�8tess oT epD��� Address of authorized person
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