HomeMy WebLinkAboutMortgage_Richeson����4 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
�i'� FOR DEDUCTION FROM ASSESSED VALUATION o t Year
., .��/ SUte Fam 43709 (R6 I 5-06) ' - � . � .
� Pre+aibeC Dy Departmem of Laal Gwemment Finarxe
INSTRUCTIONS: File Mark
To be �led in peison or by mail with the CountyAuditor of the county where the property is located. ����
Filing Dates: 1) Rea/ Property: Dunng tl�e 12 months befom June 11 0l the year the deduction is� 7 a��rvr
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 o/the year the deduct�a7'rs�e e/fective.
See reverse side for additional rnstructions and qualifrcations.
ApplicaM (c�er or conhact buyer_
Assessed vafiis o� roal property as of
Mazch t, eunen! year
If no, what is his / her eaact ghare of
name on recard b dil
�me of moRgegeo a
Key number / legal description
��'fl� ��
Mortgage / Contrad ii
March 1, current year
applicant, indicate below:
of mor� a contrad seller (number and
a oflrer owner or
easignee (number
mortgage
Record number �/►� � r� O D
-( d
Page number
unpaid as of I Is the applicant Ihe sole legal or equitable
owneR ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
�Ci►/�..
aty, state, ZfP
cratx_: ZIP COde)
s the property in
❑ Real Pmperty ❑ Mobile Home (IC 61.
�oes applicmM own propeAy in arry other h Drawer NO..Q,�, -,,. Has this dedudion been requesled on
�.? Oo
county in Indlana? • property for wrrent yea�? � Yes ❑ No
C8CC1 1�`�. ....��
approved in the amount of:
20 � I �p
SignaWre _
L7 I 20 I 20 20
1
County Auditor
20
Date
20
We certify under ihe penalty of perju that the above and foregoing infortnation is true and corred and that the applicants was / were
lesident of IrMiana and owne�r�of e a ementioned property on March 1, 20
Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
of authorized person