HomeMy WebLinkAboutMortgage_Winklerj�� � STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
'i' � FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
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� Presaibed by DepaNnent of Laal Gwemment Fi�nce
wsrRUCnoNS: JAN 1 5 ZUuoF�ie Ma�
To be filed in person o� by mail with the County Auditor o( the county where the propeRy is locat d
Filing Dates: 1) Real Property: Dunng the 12 months befoie June Il of the year the deduc6on is�
2) Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March GiBSheNy����(e y�(jqp7s lo be efiective.
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See reverse side (or additional instructions and qualfications. '
Appl' nt (owner or contracf bu er- see restridions on reverse side)
Taxing Distrid ' Key number / legal description Record number
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ssessed value of real property as of Mortgage / Contrad indebtedness unpaid as of Is the applicant the sole legal or equitable
March 1, curtent year March 1, cunent year owner? ❑ Yes ❑ No
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If no, what is his / her exad share of interest? If owned with someone other lhan spouse, indicate with whom.
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If name on record is different lhan that of applicanf, indicate below: I he prope in queslion:
❑ Real Pmperty ❑ Mobile Home (IC 61.1-�
e of mortgagee or contrad seller ` ,
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Address of mortgagee or contrad seller (number and stieet, city, state, ZIP
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Name of assignee or other owner or holder of mortgage .........
Address of assignee (number and street, city, state, ZIP code) C'� ��� �` �. ...
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Does applipnt own property in any other If yes, what counry? What Taxing Distrid? Has tn�s aeauaion oeen requested on
county in Indiana? property for curtent year?Q Yes❑ No
COUNTY AUDITOR
Deduction approved in the amounf of:
20�� 20� 20 20 20 20 20
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Signature County Auddor Date
We certify under the penalry of perjury lhat the above and foregoing information is true and corred and that ihe applicants was / were
sident of Indiana and owner of the aforemenlioned property on March 1, 20
Signatu[e (�ner full ) Person authorized by duty executed Power of Attomey
� or by IC 6-1.1-12-.07
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Full �esident address of applipnl Address of authorized person
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