HomeMy WebLinkAboutMortgage_Greer (3)"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year
• FOR DEDUCTION FROM ASSESSED VALUATION
� . Sta[a Fam 43709 (R71 / 609)
�` Presaibed M �eP��N at Laral Govemmenl Fi�nce
�STRUCTIONS: yIa�
To 6e filed in person or by mail with the CountyAUditor or Counry RecoNer o/ the counry where the property is located. u�7 p� � 2
Filirg Dates: 1) Real PropeRy: Must fJe dunng the }rear /or which the deduclion is sought. �� County Audimr
2) Mo6de / Manuladured Homes rrot assessed as Real Prope�ty: Mus! file dunng Ne tweNe (12) monfhs r� Remrdw
before March 37 o/each yearthe deduclion rs sought.
See raverse side (or additional inshuctions arM qualifications. \
MM�nf (owne� w �Dnhap buyep- see 25MCt'ons verse side)
1 / 1 ..
1 vaAie d mal P�Y as of
nvrentyrar
Iq. W�12t 6 �1L5 / iMl 0X2G S�1JfE O(1(IiCRSi�
If name on recoN a dAtrlent fhan Nat ol appGtanf, uidipte bebw.
Name ot mort9a9ee a
�
irress unpaid as
se0er (nwnbe� and sf2e; ciry, sfa.e. /F� ZIP cade)
Name of assignee w other owner or hdder ot mwtgage
ALCress of assignee (numDer arx/ stree; dry, sfate, a
Ooes appli(ant Ovm ptoperty in any oNer
counryinlMana? � Yes ❑ No
.
DeduCion aPProved In �tre amount of.
20 20 20
Signanne W Co�u:b nuaiwr
mtlebtedness unCaid as d
date
If o�meG wiN someone WMr than spouse. mdicate w%h wlnm
(� 2t� � ��.J F�
��
09-3�3�1
20 � 20 _
Counry
Y� u No
IS 1hC DroPenY III QIICStlqll: M11U3PJAS52S5l.d
I] Real Property ❑ ArmuallyPssessed
Mobile Hame fIC G
tor turrent yeaR
20
reQ�ested oo v�v�r
❑ Ye5 ❑
Date (monN, daY• Y��)
20
I I We certify untle� the penalty of peryury that Ne above arW foregoing infortnatlon is We and cortect and that the applirant is a resident of Indiana arM
owner I contrad buyer of ihe aforementioned property on date application is filed.
I7✓+�.�wnefs hA name) �% DaTe (rt�th. daY. YgeA
67.142-0.7
AOdress of authoraetl perwn (num6er aM svee4 ciN, std�e.