HomeMy WebLinkAboutMortgage_Asberry (6)Y�� y STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
= FOR DEDUCTION FROM ASSESSED VALUATION Coun To hip Year
I �
:. «. y Stele Fam 43709 (R6 / 5�06)
Presoibed by Deperiment of Local Gwemment Finance
APR 2 2007
INSTRUCTIONS: File Mark
To be filed in person or 6y mail with the County Audito� ot the county whe�e the prope�ty is located.
Filing Dates: 1) Real Property: During the 12 months 6efore June 17 of fhe year the deduction is to be effecdve �
2J Mobile Homes assessed unde� IC 6-1.7-7: Between January 15 and March 2 0l the yeai t¢e deducUorri$tabe eNective.
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See reverse side fo� additional instruc6ons and qualifications.
Ta�ting
contrecl
SBB
Assessed value of real property as of
March 1, curtent year
If no, what is his / her exact share of
O!1 fEVBfSB
/ legal description
•// -%j -a� -Q�? • �35 -Q�t�
March 1, current year
If name on record is different than that of applicant, indicate below:
oi mortgagee or conVact seller�.,
Y� "'!�� I C
ss oi mortgagee or contract seller (number
as
�
: nwn�ci � O � �/
Is the applicant t e sole legal or equitable
owneR es � No
If owned with someone other than spouse, indicate with whom.
street, ci(y, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and slraet, city, state, ZIP code)
Does applicant own property in any other I If yes, what county?
county in Indiana?
approved in the amount of:
20 �� 20 ��
n P
� Real Property � Mob� Home (IC G1:
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Card NO. ...
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Taxing District? Has this deducuon ��,.... _,: sted on
property for current year? ❑ Yes❑ No
� / �� COUNTY AUDITOR
��
20 D 9 20 20
P
County Auditor
20
20
I I We certity under the penalry oi perjury that fhe above and foregoing infortnation is W e and cortect and that the applicanLS was / were
�sident of Indiana and owner of the aforementioned property on March 1, 20
full name)
% � PJ S S'f�or.�,.on1� �(�r� nce�+/J
Person authorized by duly executed Power oi Attomey
or by IC 6-1.1-12-.07
ofauthorized person