HomeMy WebLinkAboutMortgage_Pantelis°^� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
sta�e Form aa�a� (Re i z-0»
�' � Prmvibed by Depa�menl of Local Go�emment Firence
�II�
iNSrnucnoNs
To be filed in person or by mad wifh the CourttyAuditor o/ the couirty where fhe piope,ty is bcated.
Fd'o'g Dates: 1 f Real Property: Dunng the 72 montlis belare June 11 d the yrear Ure deduction is to be e/lective.
2J Mobiie Homes assessed under IC fr1.1-7: Befween January 15 end March 2 0/ Ure year the d uclion is to be elfective.
See reverse side for additional insGvctions a� quali(cations. � �EB 1 3 Z��9
nppicam (ame` contrad 6uyer - see{@�iictians m rev=rse sde)
uii �
DiSri�t Key n I legal d�aiption
.O
Assessetl vahie ot real popaty as of Mardi 1. aerent yeer Mortgage / Co
aiRrld ya
If na whal is his / her exad share ot inlerest?
m recnrd is diRerad Ihan lhat
mortgagee or
belovi
mongagee or conUact seller (num6er arM sfreet dty.
Name of assigrree a olher wvner a hdder of mortgage
Address of assignee (nunber aiM sVeeG city, 9ate, :
Doas applirad own popeM1y in arry dher
county m Indara7
❑Yes ❑ No
DetluUion apprwed in Ne amounl of:
20 20
SignaWre of Coun�y Auddor
mdeWedness unptid as of March 1.
D I':111' G'� � � . d7`.l-.1�� . . . . . . ..
�..11'(� ���...��..........
� 39, 4 9� . -
2O � N_ � ___
Is Ihe app5�nt Ihe sde legal or e[ryi�ade mvne�
❑Yes ❑ No
spouse.'uWicate with whom.
is Ihe praperty in quesGm:
❑ Real Property ❑ Mobile Home QC 61.
Has ilis dedudian 6een
ror a,rrem yean
20
uestetl on poperty
❑ Yes ❑ No
�ale (mmfh, tlay, yea�
20
I/ We certify under the penalty of perjury that Uie above and foregoing infortnation is true and corted and that tlie appiicants was / were a resident of
Indiana and owner af ihe aforementioned property on March 1, 20
n.af�uP rorvnah hAI �ume) /1 . Dale (nq4�+. daY. Y��)
� / �.�
(nurtrber and s8ee1. dfy, state. aM ZIP mde)
ioa s. yd�
aulhor¢etl by duy exewted
w
�
persan (numbeiaMStreeLaty.state.andLPoode) -