HomeMy WebLinkAboutMortgage_Reed (7)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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� PmSCnDed 6y Department of Local Govemment Finance
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INSTRUCTIONS: �. �File�Mark� �
To be /iled in person or by mail with the Counry Auditor of the county where the property is located. "{ ��
Filing Dates: 1 J Real Property: Dunng fhe 12 months before May 11 0/ the year the deduction is to be ef/ectivet � � j;
2) Mobile Homes assessed under IC 6-1 J-7: Between January 15 and March 2 of the year_the �eductron:is to be effec6ve.
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See reverse side for additional instructions and ouali(cations.
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Applicant (owneror contract buyer- see 2sfnctions o�7�everse si ) ,'`y q� ,�;-f�.
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Taxing District Key number / legal description Record number
Q� 9— Q/ �p S5 -CQ Page number
Assessed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the� ole legal or equitable
March 1, wrrent year March 1, current year owne(? [�'es ❑ No
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If no, what is his / her exacl snare of interest? If owned wilh someone other than spouse, indicate with whom.
If name on record is different than that of applicant, indicate below: Is the,Property in question:
LYFieal Property ❑ Mobile Hane (IC 61.1-�
��ne of mortgagee or contract seiler
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Address of mortgagee or contract seller (number and st2et, city, state, ZIP
Name of assignee or olher owner or holder of mortgage
Address of assignee (number and street, city, state, ZIP code)
Does applicant own property in any other If yes, what county? What Taxing Distrid? Has this dedudion been requested on
county in Indiana? property for current year? �] YesO No
COUNTY AUDITOR
Deduclion approved in lhe amount of:
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Signature County Auditor Date
'� We ceAity under the penafly of perjury that the above and foregoing information is true and corred and ihat the applicants was / were
esident of Indiana and owner of the aforementioned property on March 1, 20
Signatur (ownefs (ull name) Person authorized by duly executed Power of Attomey
����'�— or by IC 6-1.1-12-.07
ull resident address of applicanl Address of authorized person
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