HomeMy WebLinkAboutMortgage_Powers (7)^�� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
__ , FOR DEDUCTION FROM ASSESSED VALUATION
� s� Fw,,, a3�oe (Rn i s-ael
,,,,, � rresvieea M DeaaNnem ot tncal Goremmem Firence �
INSTRUCTIONS:
To be (Jed in person or by mail witA the CountyAuditor or Counry Recorder of the wunry where the property
Fding Dates: 7) Real PropaRy: Must file durirg the year for which Ne deductbn is sought.
2) Mobde / Manufactured Homes not assessed as Real PropeRy: Musf file dunng the hveNe (�
6efore March 37 of each year the deduclion is sought.
See r�verse side for additmne�nstrticfbns erM qualficetions. ^
(owne� or convarY 6uYe see fstrc0ons q� pverse sda)
AsipssW ralue d IPaI ptopPJly as o(
Ma�31 1. artent yrar
Ii m, what Ls ha / hu eaarY share o'�
(1 `wrre m �emld is tliffe2nt Nan C
�-,-
Mortpageq/
Mart3� 1
tr�dicate Eeb�r.
-oo�. oa�t-oa
MeCteEness unpaid az of Moriga(
Name W morega9ea or mnvaU se9er V � w
LJ
Addtest of martga9ce or mntracl sWer (numDer and sheet uN. sb�. ard LP code)
Name of assignee m oNer ovmer or hdder W mortgaga
someone
bteEness unPaW as ot b me appocant me sde
le�l w epu�ta6le ow're/!
❑ Yes ❑ No
sPOUSe. mdrate wiN whan
Is Me P�OeRY in Ouestian: AnnuaM Aasessed
❑ rteal Roaenv ❑ ivmuaM ws�sed . . _
AAEfsvs af atignee (numbar aM sheeL �: s�ete. an ���r �y� -{
pI Ilr 1
Oces eppliqm wm WoG�Y �^ aM �e� �O � Has Nis EWUYim Eecn
munty m IMmna? � Yes ❑ No tar a'rent Yea�?
20
i/We
"v�tlieamountof: ���}�� q8-5y0
fis:5�7
20 _ 2q _ 20 20 _ 20 _ 20 _
tw Caunry Date (mwvh. daY. Y��
�he penatty of perjury Mat Ne above and foregoing infortnalion is We and correU aM that the applirant is a resident of Indiana aiW
yer ot ihe aforeme�rtioned property on date apP�iralion is filed.
(iwm0eran0 sbeet �}: stafe, and LP cotle)
pp�5p� auNor�d 6y dtly exeated PawM alAttn�eY ��' IC 61.7-72-0.7 .. I Date (�wnN. EaY•
Add2ss of auCror'¢eE persm (number arM sbeet my. stafa. enC LP coEe) . .