HomeMy WebLinkAboutMortgage_Baker (8)ry* STATEMENT OF MORTGAGE OR CONTRACT INDE
_ FOR DEDUCTION FROM ASSESSED VAIUATION
Slate Fortnl3709 (RB / 2-07)
S � Resrnbed by pepanmant of Local GovemmeM Finance
iNSrnucnoNs
Coun Township Year
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AP R F� h"�809
To be filed in person or by mai wi(h the CourttyAuditor W the couirty where the property is bcated.
Fding Dates: i) Real Property: Dunng fhe 12 monMs before June 11 d dre year the deduction is fo be effeclive.
2) Mobile Homes assessed urtder IC 6-1.1-7: Behveen January 15 and March 2 0/ fhe year the deduction is t
Sse reverse side /or edditional inshuc8'ons aM qualifications.
GIBSON CO� AUDITOR
(Qr^erormntrad wyer-see ies6icfzr.s
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T����J IK�(Y /l ��
w�m,.�aa�aov�nr�du�b,,.a.,�r�. T
reme m recartl is difiarent ihan thm af applicant, indi�le helaw:
Name of mortgagee or cmlract seller
of moM1gagee or conUati
- ReCOrd Page numbel
•00 _ �97 -oa-� O �a�7
u,em�edness unpaid as af nlara, 1. �s ihe appfim,f uie sde �egal u aq�riude wmen
�iQ. QQ� ❑Yes ❑No
a�d sbael �: sfate; ard LP mde)
Name of assignae or ather o«na or hNder of mortgage
� � �g� ��� ��. �. ��a. �
ooe, appi�ara own propeny in any olher
courrty vi Indana7
❑Yes ❑No
Deduction appmved in lhe amaunl of:
,��j��
I/ We certify undm(M1e penalry
Indiana and ovmer of the atae
�riatwe/QwnalshY�narre) _
sortiewie
r
spouse, indicate wifh wtwm.
Is Ihe popeAy in quesUm:
❑ Real Pfooertv ❑ Modle Hame
3
,� ��,�, S����LEYo a��
_ /��% " ; ❑ No
cour+TV auoi
zo zo _
—�
a�- �o��
20_ � 20.
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that the above and frnegoing infortnation is We and correcl and fhat the applicants was / were a resident of
P��Y on March 1. N1 _ � . _
sta(e.
IC G1.Y72-.07
person (numbe�endstreet, dty. state,
Date (month, daY. Y��
Da1a (mmtl+. day. yean