HomeMy WebLinkAboutMortgage_Bryant��� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION �
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Aesaibed by �epartment af �ocal Gwemmeni Finance b ��\O �� `
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INSTRUCTIONS: / �
To be filed in person o� 6y mail with the County Audito� o/ the counfy where the p�opeRy is locat .
Filing Da[es: 7) Real Property: Dunng the 12 monfhs be%re dune Il of the year the deduction is to be e�i
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 of th� ��r t
See reverse side for additional instructions and qualifrcatrons.
buyer-
Taxing District �
' l/��A
Assessed value of real property as of
March 1, current year
If no, what is his / her exad share of
on reverse side)
/ legal description
a6-la •o�-Ya/ -m3. 7t�5-a=
Mortgage / Contrad indebtedness unpaid as
March 1, current year .
If name on record is difterent Ihan that of applicant, indicate below:
mortgagee or conVad selier
Record
number
Is the a
owner?
'CP�j'P���a S�et
R �� °
�c°Yowns ' Year
e
P�S��C �9
.- 50t�
�
deductiii�i �'� td DA 9�tive.
`�6� ,Q o'
� legal or
❑ No
If owned wilh someone other than spouse, indicate with whom.
property
❑ Mobile Home QC 61.1
Address of mortgagee or contrad seller (number and street, city, state, ZIP __
Name of assignee or other owner or holder of mortgage
ll ra �vCt- NO��.. . ��.
Address of assignee (number and street, city, state, ZIP code) � iy
. �
Does applicant own property in any other If yes, what county? What _,�/ a 1�f �• ••......,, �uested on
county in Indiana? �'� 3 s"Q ���. o � • • • " • ] Yes ❑ No
Deduction approved in the amount of:
20 Tl 20 � 20 � �
P p P
Signature
COUNTY AUDITOR
20
County Auditor
20
20
Dale
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We certify under the penalty of perjury that the above and foregoing information is true and corred and that the applicanls was / were
resident of Indiana and owner of the aforementioned property on March t, 20
�nature (o full nar}�e) � Person authorized by duly exewted Power of Attomey
�� � � or by IC 6-7.1-12-.07
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Address of authorized person