HomeMy WebLinkAboutMortgage_Stiles� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
� � FOR DEDUCTION FROM ASSESSED VALUATION
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PrescnDetl by Department of local Govemment Finance
Year
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INSTRUCTIONS: �' 1LFile.Marti '-�
To b= Fled in person or by mail with the County Auditor of the county where the property is located.
Filing Dates: i) Real Property: Dunng tbe 12 mon[bs before May 11 o)the year the deduction is to be effec�iv,gP l� � Z003
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the year the deduction is t�ffect/ivIe.
See reverse side for addifional instructions and qualifications. V
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-seeresrncnons on
Taaing
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Assessed value of real property as of
FAarch 1, current year
no, what is his / her exact share of interest?
Key number / legal description � Record number
03
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MoRgage / Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1�,..;rrent year owner? ❑ Yes ❑ No
If name on record is different than that of applicant, indicate below:
of mortgagee or coniract seiler
If owned with someone other than spouse, indicate with whom.
Address of moRgagee or contrad seller (number and street, city, state, ZIP
of assignee or other owner or holder of moRgage
Address of assignee (number and streef, city, sfate,
Does applicant own property in any
county in Indiana?
approved in the amount of:
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Signature
Is the property in question:
❑ Real Property ❑ Mobile Home pC 61.1-�
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If yes, what counry? What Taxing Distrid? Has this deduction been requested on
_. property for current year?� Yes� No
20
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COUNTY AUDIT v�- �7G c�
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County Auditor
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certify under the penaity of perjury lhat the above and foregoing information is true and correct and that the applicants was / were
lent of indiana and owner of the aforementioned property on March 1, 20
tull name)
Full resident address of applicant
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Person authorized by duly executed Power of Attorney
or by IC 6-1.1-12-.07
Address ofauthorized person