HomeMy WebLinkAboutMortgage_Owens^•* STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION
Slate Fartn 43709 (RB / 2-07)
�' � Prcunbed by Department ot Local Gavemment Finance
,u.
�NSrnucnoNS:
To be filed in person or by mad with Me CourrtyAuditor W the county whe2 the pioperfy is located.
Fding Dates: 1) Real Property: Dudng the 12 months be7we June 11 0l the year the deduction is to be efleclive.
2) Mobile Homes assessed undar IC 64J-7: Behveen January 15 and March 2 0/ fhe year fhe deduc6on is to���egive. ZQ� 3
See ieverse sde !a additional insWctions and qualifications.
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Applira udwnfrad6uyer-see m ve ) �y ��
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T' isirie . Key riumber / legal desaiplbn Remrd number d
U d
A� value of real popaly as of Marrh 7, arren� y�r Mwtga9e / ConVad ind�tedness unpaid as of March 1, Is Ihe appGmnt Ihe e legal u equitade owrie(
artent year ( ) �
If mme
is his / her exacl
o�
intlipte below:
Address of rtw�agee w mnlract seller (number aM s7eeG dty. stale. arM ZIP code)
Name of asvgirea d alher awner or hMder a( morigage
Address of assignee (number aiM s6eel. dty. sta(e. and ZlP mde)
operty in arry oiher
❑Yes ❑ No
Deductbn approved in ihe amwnl
zo oY � zo�
If yes, whal
zo I zo
3 ❑Yes ❑No
If wmed with someaie dher �han spouse. �cate with whom.
Is the P�WartY in quesUOn: .
❑ Real Property ❑ Moh7� w�^^ "^'...1 �
` _ —
—(/ytlQii« ; 0�0�� -
Drawer N ................
...
�, a.395
Card NO• ..........
� 41,1�03.°-- ���
Whal Tacing Distnct? -_ -.. rwenY
. ��i r
I ❑Yes ❑ No
zo � zo _ � zo
SigreWreo CounryAuddor �-- ICamry IDafe(monN.day,yea�
I! We certify under Ihe penally of perjury that the above and foregoing infortnation is hve and correct and ihat ihe appiicants was / were a residen[ of
Indiana and ow�er of ihe afwementioned property on March 1, 2b
� I Sig�UUe (awners hdl nartre) ��
oa� (R,mm. aar. r��1
� '
� s
Pasvn
address
erzea�ted Power
auUmraedpersan (num6erarMstreel,
tity, sfafe, an0 1LP aode)
.l i i.�.e o .C.�il.,
or by IC G1.1-72-.07
code)
7
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