HomeMy WebLinkAboutMortgage_Newman' �VI}��Sv���2 � �
- d � STATEMENT OF �ORTGAGE OR CONTRACT IIVDEBTEDN SS i `� ��
/F�` FOR �EDUCTION FROh9 ASSESSED VALUATIO� � Coun Townshlp �
�` '�� Sta;a Fartn 43709 (R7 �/ 6-09)
���� Presctlbetl by �epartment o; Lacal Gover„r�enl Firance
INSTRUCrIONS;
. " " � File Marh
TohefiledinpersonorbymarL �Iny p [ �-
IYIFiI H J �Q'� Fortn(JedtNlh:
Flling Dafes: fJ Real Propelty Mus; be completed ar,d d^.ed In fhe calendaryearforw6lch fhe deducflon ls sougbt.,
Mus;6e(ledw!(hfheCauntyAUdiforcr..,ovnfyRecarderofthewuntywherefheprop4rj�s ❑ Ccuntyqudi[o; '
on or before January 5 of tbe lmmedlz,elysucseeding calendar year.
" 2J�do6ile/ManufacturedHomesnolassessedasP.ealP�oper}YMusffilewi(htheC�o�un� tyAuditorof( � CountyRecorder
_ . covnty whera ;he property ls located rfudng the hvefve (12J months 6elore Mar���0
dedvc(ion is sougAt. ���AUDITOR
See �eve�se slde foradCltlonallnsWc(rons and qualificatlons.
Appii�t (ow�er a ron(racf 6:rye�- sae resWc(ions on raverse side)
r� + l . �JewmR,v
�TedngDlstrlcl aynvmbeNhaaldesr11p0o� � '
�� Lr -�d-3o-3ao-p �O Rarordnumhe� Paenumber
� aa. -oi 8 d0 I 7
Assessedvalueot�eelpmpertyaso( Mortgage/COntractlndehtednessunpaldasat Motl a e
March 1,urtenl yeaf Ma�ch 1, curren[ year G 9 / Con4act Indebtednesa unpaid as of �s Ihe appOcanl lhe sole .
dat ( app �catFloJ,� ^'� ' {eyal or equlta6le ovrtieR �
Ifno,wryatishislharexacfsnafea;lnterest7 �" Qw' � Ye: ❑ No
� � It awned wlih somevne olherthan'spouse, Indlrale wlth wpom
� If name on record Is dilfarant Nan Ihat of applicant, Indlca[e tielaw: .
. - . Is;hep`opertylnques;lon:Anr,valtyASSesseE �
� � � � �RealPmperty ,Q?,nnaallyASSessed
� Name o; mor,yage oncontract sellerp ' MohOe Home IC 51.7-7
Addresso;mortgageaorc�ac�l�e�(numberands' ef,��,'anCZ/P�cotlej ' � ��'��/ � �
' ' . Nameo(ewlgneeorolherownerorholdera;mongage
Address of assignee (num6e� and strae; crty, sla(e, and Zlp code)
� �oes aPpficant own property In eny oNer It yes, wbat coupt 7
• wunty In Indlara7 I Y �at7az4fg �IS41ct7 J-las lhls deCUCtian been re^yues@d on pmpeRy.
. '� Yes ❑ No ' . " ' , forwrtentyeaR �
❑ Yes ❑ No
CoUNiyAUDITOft
.. Deducllan approvetl In lhe emounl o(: .
20 _ ZO _ LO _ ' 2O _ 2O . .
__ 20 _ 20
SlgnaWreolCOUnlyAUdllor Counfy '
. Oace{monN,�day. y.°aq .
. I/ We ceNfy under Ihe penalty o( perJury that Ute above andloregoing informa4on Is true endcorrect end that Ihe applicantis a�resident of Indlana and
owner / contract buyer of lhe afarementioned praperty on Eate applicatlon I" d �
� Signatur�owner'sfu//nam l . ' , '
X�� �/ Oa!= manfl�,day, year)
. FuIlresldentaddressofapliwt(num6erands6ee(,city,stafe, ndLP �'�_�I I
�'S7 � �cce �SD� j � .,� 1 �/ �-t76�10
Perxon auihadxed by duly ezecmeE Powar ofAttomey or by1C 6-1.7 7p-p.7 � �
' . . Da:_ (month, day, yea� .
Address o( aulhvrized penon (nvmberand slreef. Gty, sfale, and LP wde)