HomeMy WebLinkAboutMortgage_Coomer (7)�" STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION Coun 7ownship Year
•«• , Prdescribed by DepaRrtmentO.oaf Local Govemment Finance � � � � � �
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iNSrRUCnorus: MAY O 1 200�31e Mark
To be filed in person or by mail with the County Auditor o/ the county where the property is located. , // /�
Filing Dates: i) Real Property: Dunng the 12 months belore May 11 of the year fhe deduction is to be_et�ec6ve ,.�,�{Q�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and Marc�h� G BSOfv��l�e�d�edu�ct�rrq�s to be effective.
See reverse side for additional insfructions and qualifications.
Applicant(ow ern orcontractbuyer-seerestnctio� re�side)
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Taxing Distri � Key number / legal description Record num�r _��Q �
7
'• /`) / Q, Ga 7� � Page number
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Assessed value o real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant thy sole legal or equilable
March 1, current year March 1, wrrent year ownef� �Yes ❑ No
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If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
If name on record is different than ihat of applicant, indicate below: Is the pj operty in question:
LSReaI Property ❑ Mobile Hortie (IC 61.1-�
�ame of moAgagee or contract seller
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Address of mortgagee or conUad seller (number and st2ef, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address of assignee (num6er and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has lhis dedudion been requested on
county in Indiana? property for curtent year? � Yes ❑ No
— � � � C NTY AUDITOR
Deduction approved in the amounl of:
20 �� 20 20 o S 20 20 20 � 20 � q
aA— /' P P P
Signature County Auditor Date
I/ We certify under the penalty of perjury that the above and foregoing infortnalion is true and corred and that the applicants was / were
a resident of Indiana and owner of the aforemenlioned property on March 1, 20
Signature (owners (ull name) Person authorized by duly executed Power of Attomey
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Full resident address of applipn Address of authorized person
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