HomeMy WebLinkAboutMortgage_Jones (10)"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
_ ; FOR DEDUCTION FROM ASSESSED VALUATION
Slata Farm 43709 (R71 / 6-09)
S P p�y� y�, pynyh�nt af Loral GovemmeM Frence
File Mark
1NSTRUCl10NS: I1I�,I
To be filed in person w by mail with !he CountyAuditor or Counry Recorder o/ the oounty where the property is focated.J V Iv .
Filrtg Dates: 7f Real Pmperty Must tle dufirg the year /or which fhe deducfion is m ht.
2) Mo6de / ManuFactured Homes rat assessed as Real Property Musf Ae dunng the tweHe (12) months '�' �unry Auditnr
6efore March 31 0) each year the deduction is sought. nry Remrder
See reverse srde foradditional instnictions aiM qualifications. GIBSON C
AppGmnt(owreraroontrattbuyer-seere5ricnppsmre vde)
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Tab g istrict- Key rwmher / leg Cesoiption RecoM number Page numDer �
� a�-�a-� -�ai-ooa.6o9-� aor � a a� �
p�operty az W Mo�qa ge / Contract inEebtetlness unpaid as ot Mortgage / ContrarY intlebtetlness unpaid as of Is Uie aPdirant ihe sde
Mart�h 1, 2a�rtelrt year date ot aPP��^ �gal w eWilade oxne/1
�n "] ti 0 � ❑ Yes ❑ No
ra. what Is his I her exad share
If rurt�e m recpd "a dAfemnt ihan Nat of appGCant, uWkate bebxc
Name oi mMgagee or mntraU seller �
Address of mortgagee w contraa se4er (numba� and sWet, ciry, state. aM ZIP code)
2
� V LC� � p �
Aipnt own property in any oNer
IMian2? �
❑ Yes
DeducGan appiwt.W in ihe amount of:
mortgage
sfate. antlZlPCade)
� - ��.,,�����
N�
2o i �_ i �
����
with sorneone aher Ihan spwise. indinte with whom
Is Ihe property in Ques6an: Mnually AssessM
�Reai PmPertY ❑ Armual�Y %�sse`.sed
a 95 A � -- -
What Ta�drg D'atricl7
COUNTYAUDROR
zo
Caunry
Dra«�c,• NO..°�Ol.�.........
Card NO. . ..�c� rI(P ......
�°- �'�i�9«�. %
Date (mortlh. tlaY Y��
I I We certify under the penalry of�erjury that Ih�bove arid (oregoing infartnation is W e and correct aM Nat the applkant is a resident of Indiana aM
owner / contracl buyer of the mentioned p perty on date application is filed.
Sig re(owners h�u �me) Date (rtmrh, day. yea�
F I rrsiCent etltlr�s of appf t(numb nd shee( �, slate, a Z!P mde)
�
Person aWMaetl dtdy ezetvte0 Power W Attonrey w by IC G1.1-12-0.7 �ate (npnth. day, yBe�
Pddress of aulhar¢ed person (num6er aM sbeeG ary, sfafe, aM LP mde)