HomeMy WebLinkAboutMortgage_Beck (3)STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
�- FOR DEDUCTION FROM ASSESSED VALUATION
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� Prexribed Dy DepaNrent of Loca! Gcvemmeni Finance
INSTRUCTIONS:
Coun Township Year
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�1 � 11..�
File Ma
To be filed in person or by mail with the County Auditor of the county whe�e the property is located. J U N Z� Z���
Filing Dates: 1J Real Property: During the 12 months belo�e May 11 of the year the deduction is to ba effective.
2) Mobile Homes assessed under IC Sf.l-7: Behveen January 15 and March 31 of th�e,year the deduch/�on is to be e ective.
See reverse side /or additional instructions and qualifications. /�-�"^�`'�'J`��'`"`�
�IBcnrJ r•�....�-.� �I!OITOR
Applicant (owner or contract b�yer- see restricfions on reverse side)
Taxing Distrid Key number / legal description Record number
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Assessed value of real property as of MoRgage / Contrad indebtedness unpaid as of Is the applicant �he;ole legal or equitable
March 1, curtent year March 1, current year owneR ��`�s ❑ No
_,, _
If no, what is his / her exacl share of interest? I( owned with someone other than spouse, indicate with whom.
If name on record is diHerent than that ot applicant, indicate below: Is the property in question:
Properly ❑ Mobile Hmte (IC 61.1-�
� e of mortgagee or conVad seller
1 �
Ad ress of ortgagee or conVad seller (number and street, aty, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does appliqnt own property in any other If yes, what county? What Taxing Distrid7 Has this deduction been requested on
county in Indiana? property for current year? � Yes ❑ No
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COUNTY AUDITOR
Dedudion approved in the amount of:
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Signature County Audftor Date
�/ We certiy under lhe penalty of peryury lhal lhe above and foregoing infortnation is true and corred and that the applicants was / were
�resident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners full name) Person aulhorized by duly executed Power of Attomey
� ��� or by IC 6-1.1-12-.07
F I resident address of applicant Address of authorized person
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