HomeMy WebLinkAboutMortgage_Hope°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS T hi Year
FOR DEDUCTION FROM ASSESSED VALUATION
Slale Fartn 43709 (R8 / 2d7) .
S � Prasrnbed by DeparUnenl of local Govemmenl Finance �
File Mark
INSTRUCTIONS: , /
To be fiied in person or by mad with the Court(yAudifor o/ the county where the propeify is bcated. :rll ,Q/j"s-y
Fding Dates: 1) Real Pioperty: During the tt months belore June 11 0/ the year the deduction is to be eBec6ve. �� �` (/
2) Mobile Hames assessed under IC 61.1-7: Behveen January 15 and March 2 of Ure year the dedur�'��� �e .AUDITOR
See reverse side /or additiona! insWc6ons and qualifications. -
Mq�( d�+�A��-seere�mreversesde)
-O - - �� � -O —
1. a,rera year M«+gase � coniraa inaewedrress unpaia as of Ma.cn 1,
anent�,�OG /,
CJ
If ��nat is his I her ezaq share d irrteresl?
If reme on record is diRe�art than Ihal af applican4 ��dk
Nama of matgagea ar cuMact seller
Address of morlgagee a oonUaQ seller (iwmber d�
Name of ass9�e a alher o.vr�.r a hdder at mortgage
Atldress af asvgnee (romiber aM sUeet. ciry, �ate, and
Does apqi�aM own praperty in anY dher
couMy in Indiana?
❑Yes ❑No
�ia _�_�,
DedWbn a�
� L
SignaWre af
U�e arnount
0
eef. tity. sfate, andZlPcrode)
ZIP code)
It yes, whal caunly? N
COUNTY AUui wn
2b � 2b
County
wrrieone
Record rnunber � Page
Is Ihe appGCant Ihe sde legal w eqirilabie o.me(7
❑Yes ❑No
spouse. indicate wifh whom.
Is �he property in questim:
�2�1 Rocertv ❑ Mobile Horne (IC 61,
- amy.........
D�-:�„ ��� �o......
aya.s....... �o��
.C11'(1 \�. .......... ❑No
�a5,6o�• � 5
20
20
20
I I We certify urWer the p�ally of perjury ihat tlie above and fwegoing infortratbn is We and corteU and that Uie appGpnfs was / were a resident of
Indiana and owner of Uie aforementioned property on March 1, 20 _
,�e (owneis fidiname) Dafe (rm�fh. daY• Y�/)
'�., f'{... �b/4
FYu,,O 2sidr,nl address of applicanl (numbei arrd streel, dty, state. arW ZIP w0e)
`t � So o it, �'
Pamn aulFar¢ed by duy ezewled Pwwer of Auarrrey or by IC 67.7-12-.07
Address of aulhor¢ed pasan (number and sheef, oty. s(ate, arM Z/P mde)
V�� p� �j
oaee (�,m. ear. r�4
.__ _ _1