HomeMy WebLinkAboutMortgage_HowellSTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
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S,,,, Presaime ey �epartrt�ea a Low covemn,ara Fumnm
INSTRUCTIONS:
To be filed in person a by mail with the County Auditor w Counry RecoNei of fhe county where tl�e properiy is bdted. Q�� � Q j �
FTmg Dates: 7) Real Property: Must file durrrg Ne year (ol which the deduclion is soug�[ Counry Auditnr
2) Mo6de / Manufactu/ed Homes rat assessed as Real Property Must fi7e durbg the Melve (12) moriths ��ry R���
6efore March 31 01 eacA ysar the deducfion is sayht.
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See reverse side for addifional inshuctbns end qualificatbns.
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As�sed rahia d m�d O�PeRY aa ol Mort�ga / Conttau U
MerUi t, n+msrt Year Mard� 1, wrrnrt year
1( M. Whdl IS hLSI h!!lidG 51181H O} VISCRSt?
If nama m remd'e C�rterent Man mat ot appO�anL hMkam Eelmr
Nama ot mortBs9ee or mntre�l u9er /'�
l 1
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Address ot rtnrtga9ce or mntraG se�er (number and streaC �'. smte. a
Dces e�n[ wm P�G�Y
munry in Indana? r
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al
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SIele. entl LP mtle)
If yes. what munfy7
I No
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unpad as af �M m o�°a7P��
What Tadm,7 DistrirY7
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I/ We certify under Ne penalry of perjury that the above and foregoing infortnatia
�, owner I mntract buyer of Ne atornmentioned property on date appiicatlon is filetl.
� Slg (oxnerY/�nert�e) .
� Flm retieent a appfrant (numeer em ti�: strm, ua aoae)
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Pe15a(IaWqReACyd�dyexetuteEPOwerafPllcmBY� IC67.1-t2-0.7
Pdtlress of aW�ar'¢ed 7� (numDe�aM straet �: smfe. aM LPmde)
Rgtqy numOC Page nuTDu
G/d �
: impaitl as d Is t�e apP&ant tlre sole
kgal or equitade owne!!
� ❑ Yes ❑ No
uWimte uiN �vlwm
e property in GuesSm: MnuaOy AsscsseE
Reel Pfoperty ❑ Pfmua�yAssessed
aed m p�ape+ty
Yes ❑ I
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