HomeMy WebLinkAboutMortgage_Connor (2)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun Ti - i Townshipy �', Year
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��� PiesaiDetl by Department of Local Govemment Finance Y`
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INSTRUCTIONS: File�Mark
To be /iled in person or by mail with the County Auditor ol the county where the propeKy is located. �� J�� �
Filing Dates: 1J Real Property: Dunng the 12 months be%re May 11 of the year the deduction is to�be ef/ective���i�rTY k!S6:TG^ i
2) Mobile Homes assessed under IC 6-1.1-7: Between January 75 and March 2 of the year the deduction is to be effective.
See reverse side (or additional instructions and qualifications.
Applicant owner or conlract buyer- stnctio on reverse side
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Taxing Dislrid , Key number / legal description Record number �
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Assessed value of real property as of MoAgage ! Contract indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, current year March 1, curreni year owneR ❑ 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 applicant, indicate below: Is the propeRy in question:
❑ Real Property ❑ Mohile Horne QC 6-1.1-�
�e of moRgagee or contrad seller
Address of mortgagee or contrect selier (number and street, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Addressofass' DrawerNO...ca��Q�......
Does applicant Card NO. .....�.�.�. J...... �at Taxing Distrid? Has this dedudion been requested on
county in India u�/ I' S o. �� property for current yea(? I� Yes O No
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COUNTY AUDITOR
Deduction approved in the amount of:
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Signature County Auditor Date
' We certify under the penalty of perjury that the above and foregoing informalion is true and corred and lhat the applicants was / were
asident of Indiana and owner of the aforementioned property on March 1, 20
Signature (owners /ull name) Person authorized by duly executed Power of Attomey
or by IC 6-1.1-12-.07
Full resident address of applicant Address of authorized person
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