HomeMy WebLinkAboutMortgage_Salt.+"•� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS un T hi Year
,. � FOR DEDUCTION FROM ASSESSED VALUATION
s��a F� aa�o9 �Re i za» D E 1 1 2008
�' -- � Prestribed by Departmenl of Local Govemment Finance
FIIB rk
INSTRUCTIONS: �6µ �
To be (led in person or by mail with the CountyAuditor o/ the county where the property is bcafed. � � �
Fding Dates: i) Real PropeRy: During the 12 months before June 17 olthe yearthe deduction is to be ef/ecfive. Ci��gON COUNTY AUDITOR
2) Mobile Homes assessed under IC 6-7.7-7: Befween January 15 and March 2 o/the year Ure deduclion is to be eflec6ve.
See reverse side for addilional insWctions and quali�cafions.
Taring
Assessed rdlue of 2al popPfly as oi Martii 7, narenl
Al whal is his / her exacl share of ime2sl?
m reverse siae)
_ ,�/7 �l - �.L'Li- � � -�O �
gage / Contratl iideWedness unpaitl as oi March 1,
If name on rernrd is diRerenl Nan Uial of applicanl, indi�le belar.
Name of mortgagee or conUact seller
� �
rtaM1gagee w mniraa seiler (number and 9reel, `iry, sfafe, arr0 ZIP code)
owrrer or holder of mMgage
asvgnee (n�m+ber aM stieet, dty, 5efe. and ZIP mde)
Does apd�M � P��rty in any other
courriy in Intliaro)
❑Yes ❑ No
ction apprwetl in lhe amounl of:
zo v9 so
zo I zo
owned
Remrd number
Is Ihe app6mnt Ihe
spouse,
Pag1 number
(fl / $i
« eGUitaNe oaner
❑Yes ❑ No
P��rtY in question:
�I Properly ❑ Mobile Home (IC 61.
0 8� :.� �S�
Dra�ver NO..� .....
�Yes ❑ No
Card NO . .....................00
5�3 �ty � �7 �s'/
zo _ � zo _ � zo
SignaWre of CounryAUCi�or Caunry I Dale (mmN. Qay, yeaA
I! We certify under the penalry of perjury Mal Ne above and toregoing intortnation is true and corred and that the appliwnts was / were e resident of
Indiana and owner oi the aforementioned property on March 1, 20 _
dent address ot applicare (num6er antl streei. city. state. arrd ZIP cade)
�% E E7MEl�lS�w 5T /�/�.s.,G�'7d� SY-�
authorized by duty exewted Paver of Ntomey or by IC G7.1-72-.07
Atldress of aulhor¢ed person (numberaM sVeet dty. sfate, aMZIP coae)
67a
Dafe (monfh. day, yea�
eay, yea�