HomeMy WebLinkAboutMortgage_Feagley (2)STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
-" ' FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S J Stale Fofrt143709 (R4 / 16-01)
�u.
� Prescribed by Department of Local Govemment Finance ' � � 1
S Fi
INSTRUCTIONS: � �� � File Mark
To be filed in person or by mail with the County Auditor of the county wheie the propeRy is locate� 2 2003
Filing Dates: 1) Real PropeRy: During the 12 months belo2 May 11 of the year the deductip/1�4s to be effective.
2) Mobile Homes assessed under IC 61.1-7: Behveen January 15 and March 31 0/ the year the dedyc�n is to be�eHective.
See reverse side for additional insfiictions and qualifica6ons.
Applicant
buyer-
side)
number / legal
number
Q
Assessed value of real proper� as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March i, current year � March 1, current year owne(? ❑ Yes ❑ No
��f O V
If no, what is his / her exact share of interest? I( owned with someone other than spouse, indicate with whom.
If name on record is difterent than that of appliwnt, indicate below: Is the property in question:
of mortgagee or contrad seller
Address of mortgagee or conVact seller (number and street,
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
state,
Dces applicant own property in any other If yes, what county? What Taxing Distrid?
county in Indiana?
COUNTY AUDITOR
Deduction approved in the amounf of:
�Iii�f'3�]
20 �(,oJ 20 // /O 20
County Aud'Aor
� Real Properiy ❑ Mobile Home (IC 61.
Has lhis dedudion been requested on
property for curtent year? � Yes� No
�
20 �
P
/ We ceAify under the penalty of perjury that the above and foregoing information is true and corcect and that the applicants was / were
resident of Indiana and owner of the aforemenlioned property on March 1, 20
or by IC 6-1.1-12-.07
address of �plipn(y� � �Address of authorized person
of Attomey