HomeMy WebLinkAboutMortgage_Sutherland^'* STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDRES9� 7ownship vear �
� FOR DEDUCTION FROM ASSESSED VALUATION
- ' s�a ��,�� cR„ ��> FEB 2 I 101I
�' ,«. � Presaibed by DepartrneN of Lofal Gwemmerrt Fuurce
C.�, File Mark
INSTRUCTIONS:
Fortn Ned with:
To be filed in person or by mail wiN Ihe CountyAuditor or Counfy Recorder o/ the counlfn{fDg� 9.p(pL�rty .
FBirg Dates: 7) Real Property: Must file durirg the year for which the deduction is soughL � r"�N rY AUDIT pR �ounry Aud"rtnr
2J Mo6�7e / ManufaGUred Homes rrot assessed as Real PropeRy: Must file dunng the hvelve (12) months
before MarCh 31 0/ each year Ihe deduction is soughL ❑ County Recorder
See 2verse side for additional instqictbns arid qualficatiQns. „
Assessa7 rdue U real pope
Marrii 1. wrnla Year
I
'tt no. what Is his � her ewU
If rwrie on lemttl is dA1Ha
Key rnrcnber� legal tle5ai0t����' /,"-�� Z J. J`/ �/ / RetarE ni� �� Pa9.7 D v"
U p� �
Mortgage / Contraa I�Nebi� ness unpaiC as of Morcgage I Contrars mtlebtedness �mpeid as d Is Ne app5rant the mle
March 1, a�rtent y� date of aPP���+ legal or eWitade ownM
❑ Yes ❑ No
it�1? IF owned vrit� somea� oMer ihan spouse. 4dirate with whom
Nat o( aGP�i• uWinte Eeb�r.
of rtnrtga9ee a mnbact seller
mort�jagce or mntraG se4er
Name of a`�nee or other owner or
Mdress of
Oces appti�nt wm poprlty in any olher
munry in Intliana? ❑ Yes
apprwed 4� tln amount oE
�_ � �
r�v end svee; rdy. state. aM 8P cotle
morigage
slafe, andLPcade)
If yes, what muntYt
Na
GOU
20 20
VJha, Ta�rg D�
�
IS C�e O�PertY in Question: AnnuaAyl�sseSSed
❑ Real Roperry ❑ Mnually Assessed
Dra�ve'r NO.I.°�.���
, � 5808 � _
card ��o . ...............
. ��a4;5oo• °o.....
�a
'���W�'�"1iYl� .�
1 �i►-nA.� a 47�0.0� � - a /- //
I I We certfy under the p ne alry of rjury that the abo e and foregoing infortnation is We and mrtect arW that the applirant is a resident of Indiana arW
owner I contract buyer ot ihe afaemeMioned property on date application is filed.
3fabue hNrmme) �'=f /"Y Q Date (month, daY. Y��
.�
9 ent atldress of ppf�nt (num6e�antl shee4 �4; stata, and ZIP cotle)
� 5410 ,F Sf. �P-� S� /-�c �P�Q� �. �17/, yn
rson aW�O by Euly exewtetl Porer a(AIIm�eY a�' IC 67.1-72-0.7 Date (manN. Ca1; Y��
Pdd� of aulhu'ved perso� (number a� street �1: �+a. � LP oode)