HomeMy WebLinkAboutMortgage_Hughes (4),Y o
ii� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
'i' FOR DEDUCTION FROM ASSESSED VALUATION Count Townsnip Year
�� �' State Fwm 13709 (R6l 5-06)
� Presaibed by �epartmer.t of Laal Gwemment Finance j
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INSTRUCTIONS: JUN O s���/ a�`
To be fi/ed in pe�son or by mail with the County Auditor o/ fhe county whe�e the property is localed.
Filing Dates: 1 J Real Property: During the 12 months before June Il of the year the deduction is to be eflective.
2J Mo6ile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the year;Hc�e �dedat#ui is to be efleciive.
See reverse side for additional instruclions and qualifications. �-���'p!� �p JNTY � ITOR
Applicant (owner pr contracf buyer - see
Taxing Distrid
Assessed value of real property as of
March 1, currenl year
If no, what is his / her exad share of interesl?
on reverse side)
Ke}�humber / legai description Record number
�c�a �oaa
� ^ O � ' Page number " � �
1
Mortgage / Contract indebtedness unpaid as of Is the applicant e sole legal or equitable
March 1, current year owneR �es ❑ No
I��_ .�
It name on record is different than that of applicant, indicate below:
mortgagee or contract seller
If owned with someone other than spouse, indicate wilh whom.
mortgagee or contracl seller (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
of assignee (number and sheet, city, state, ZIP code)
Does applicant own property in any other If yes, what county?
county in Indiana?
What Taxing Distric
COUNTY AUDITOR
)eduction appro� ed in the amouni of:
20 �_� 20 Q�_ 20 20
P �P P
Signature
County Auditor
20
Is the property in question:
t�eeal Pro�erty ❑ Mobile Home pC 61.1-�
R�y PNUGNES
�3�T� A,Ia�E _
`��1/' / � 70�
20
Date
20
We certify under the penalty of perjury that the above and foregoing intormation is true and corred and that the applicants was / were
resident of InGiana;and owner of the aforementioned property on March 1, 20
executed Power oi Attomey
or by IC 6-1.1-12-.07
ent aifdress of appliqnt Address of authorized person
So y y� i,,i OToKA �.� y)<�`