HomeMy WebLinkAboutMortgage_Welch.f °"� STATEMENT OF MORTGAGE OR CONTRACT INDEB�DN�S �u Townsnl
_ FOR DEDUCTION FROM ASSESSED VALUATION
Sf : f s�,a F«„� ��� �R8 � 2-0�� MAY 0 2 2008
,,,. Presmbed by Departmenl of Lacal Govemmenl Finance
`�'7n �Q File Mark
INSTRUCTIONS: l� � � �
To 6e fiied in person or by mad wdh fhe CountyAuditor o/the couirty wheie the piope�ty is Ioca�t����NTY AUDI70R
Fding Dates: 1) Real Properly: During the 12 montlis befae June 11 0/ the year the deducGo ve.
2) Mobile Homes assessed under IC 6-1.1-7: Behveen January 15 and March 2 0( the year fhe deduction is to be e9ective.
See reverse side for addifironal insWCtans a�W qualifications.
P.wlicaoUewnerorconLacl buver-.vEb rezhrctid3lon ieverse side) n . .. J i� 1 I .. . � 1. .
�� ��+ `o „ _,� ,�i
��a �n,a m rea po�ny � d r.�a�rn i. wre�,i r�� M«�a
M
airten
Ii ^^�what is his I her exaa share ot interesl?
If reme on recwd is d'Alerent than that of applican4 ��icate below:
Address ot rtqM1gagee w mnUacl seller (numbu arM sireef.
Name of assigrree or W�er oxner or
DeduGion
dty 3ate. a�
as of March 1.
Is Ihe
Year
Remrd number I P� --`-'
sde �ega� w equllaae"ownel
❑ Yes ❑ No
If awned wiU� someone dher Ihan spouu, fntlicate wiili vrtqm.
Is Ihe propeAy in Question:
❑ Real PmpeAy ❑ Mobile Home (IC 67.1-7)
aim poperty in anY dher � _,(.� � \�
a7 � Yes ❑ No � J��� _ _ ,.f! (m i
amwnt of:
�� � � � ,
,
Sig�WreofCOUnryAudMr �
I/ We cerUfy under the penalry of perjury ihat
Indiana and owner oi the afwementioned proj
Sio�LUe(own�shAlnamel_ ��
denl atltl� 07 appliranl (nurt�ber and sGeet. c
aWiorae0 by Ouy ezea�ed Power of AtlwrieY �
�b��—��173
� S,baO. —
� �
Address of aulhmaed persa� (numbeiand sheel. aty, sfate, arM LP mde)
's dedudion Deen requested on praper�y
rent yeaR
❑Yes ❑ No
'� 2� 2�—
Oate (rtnnN. day, yea�
applinnts was! were a resident of
I
Dale (monN. QaY• Y��)
— Date (monfh, day, yea�