HomeMy WebLinkAboutMortgage_Bammer"' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun shi r
__ � FOR DEDUCTION FROM ASSESSED VALUATION
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S y� ° Pr�aibeC by Department a1 Loral GovemmeM Frexe
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Farm fli ed wiih:
ba �led in person w by mail with !he CountyAutlitor or Counry Recorder o/ the county whe2 the property is located. C
Fil"mg Dates: 7) Real PropeRy: Must file dunrg the year /or which fhe deduction is sought. a Co n A itor
2J Mobde / Manulectured Homes rat assessed as Real Properly Must h7e dur'vrg Ne hvelve (12) rtanths �J�� �un �de
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See reverse side Ior addifional insLuctions and qual�cations.
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Mortgage / Contract iMebtetlness unGaiE az o( Mwtgage / ConbaG udeMedness �mCaid as d Is Ihe aVd�� Ne sole
Ma�di 1, airtent year date af aPP��^ n �gal or equitahle ow`re(.�
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It rwrie on remrd a 6ffuem Nan Nat of appGrant, trMuate 6elmr.
Name of mortgagea or contract seller
mntraG se0er (mmNer eM sfree4 �+N. sbfi.
(nurnber aM atreet �: smte. aM ZIP mtlej
Does eppliraM own prqwty in any aher I I! yes, what munry7
munry in Indana? i-'1 ., I—I ..
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COUNTY AU
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I/ We certify ufWer the penalty of perjury Nat Ihe above arW foregoing infortnalia
oxmer / mntraU buVer otthe aforementioneC oropeM1y on date application is fiied.
Pelson aull�w¢ed �y duly ezeated Power
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person (numbar arM straeG city. stete,
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saon: MmiaDY A�seO
❑ Mnual�Y Pssessed
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