HomeMy WebLinkAboutMortgage_Beach (3)��A� STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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� Presaibed by Depanment of Loml Gwemment Finance '�
JUN 1 1 2001
INSTRUCTIONS: File Maric
To be /rled in person or by mail with the CountyAuditor of fhe county where the p�operty is located.
Filing Dates: 1) Real Property: Dunng lhe 12 months before ,lune 17 of the year the deduction is to e
2) Mobile Homes assessed unde� IC 6-1.1-7: Between January 15 and Ma�ch 2 q(g�� ��� i�to be el%ctive.
See reverse side for additional instnictions and quali(icatrons. �' D�
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icant (own or conf buyer- see restricti ns on reverse side)
Taxing Distrid Key number / legal description Record number
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Pa e number
r lo-�a-�-l-aaa-oo_y, i'ol-o
Assessed value of real property as of MoAgage / Contred indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, curtent year ownef? ❑ Yes ❑ No
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If no, what is his / her exact share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than that of appticanf, indicate below: Is the property in question:
❑ Real Property ❑ Mobile Home (IC 61.1-�
me of mortgagee or cont ct sell
Address of mortgagee or contrad seller (number and street, ciry, state, ZIP
Name of assignee or other owner or holder of mortgage �
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Address of assignee (number and st�eet, city, state, ZIP code) Dt'a ti1'�l' !1'�, , O//
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Does applicant own property in any other If yes, what wunty? Card ��, �"" •• m been requested on
county in Indiana? �. °,�GG^J_ 2C`� �nt year?O Yes� No
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COUNTY AUDITOR
Deduction approved in the amount of:
20 �_ 20 �_ 20 O 9 20 20 20 20
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Signature County Auditor Date
� We certiy under lhe penalty of perjury that the above and foregoing intormation is true and corred and that the applicants was / were
resident of Indiana and owner of the aforementioned property on March 1, 20 �
i ture (o rs (ull name) Person authorized by duty executed Power of Attomey
or by IC 6-1.1-12-.07 -
.
ull resident address of app nt Address of authorized person
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