HomeMy WebLinkAboutMortgage_Ziebell"� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION ��
s�e F«m aa�os �as r z-0�) /y� �
' f Presaibed bY Departrtrent W Local Go�emme,n Finance � 1
•» �Q File Mark
INSTRUCTIONS:
To be filed in person or by mad with the CourrtyAUditw of the courtty whara fhe pmperty is bcated.
Fd'ag Dates: 1 J Real Pioper(y.' Dunng fhe f 2 monfhs be(ore June 17 0/ the year the deduttion is to be e//ac6ve.
2J Mobile Hornes assessed'mder IC 6-1.1-7: Belween January 15 and March 2 0/ the year the deduttim is fo be eflective.
See 2verse side !or addtbnal insbuctions aM qualifications.
Appiirv`tl ��n r�mr�Ndd luryu- ee re4rictions m reverse �)
m � �
Disfritl Key rwmbu I legal Ees on
� �
n�d �u,e m aa po�ny as w n�� i, a.Rm r�r �ge � co�xrea inde
artent year
If:�al is his / her exact share af iMe2sl?
If reme on recard is differeM ihan iha� oF apdinnL i�nte belovr.
mortgagee u mnUaa seller (ixunber
assgrxre ar aUier owner or hdder of malgage
assignee (rxmber and street. ciry, stefe. an0
Daes applicaM awn property in arty dher
county in Indana?
❑Yes ❑ No
Deduction apprwed in Ne amaunt of:
. p._� �—
SioraWre of CauntvAUdM1Or
dty. sfata. and LP code)
yes. whet counry?
0
unpaid as ofMarch 1.
Whal Tering DisbicYl
COUNTY AUDITOR
20 _ � 20 _
r eawlaWe wme(1
❑ Yes ❑ No
spouse, indicate wi�h whom.
Is Ihe propeM in quastian:
❑ R�1 PrweM ❑ Mobile Horne (IC 61.
/ " _' ' �'�"'
uested on properry
❑ Yes ❑ No
20
Dale (mwrtA. daY Y��
20
I/ We certify under the penalry of perjury that ihe above and foregoing informaGOn is true and correct and that Ne applicants was I were a residenl of
Indiana and owner of the afwementioned property on March 1, 20 _
Date (monfh, OaY, Y��
and sfreel. dty, sfate. aM ZIP code)
authonzed
of aul7arized pasan (numbei antl s4ee1, cify: shdte. ard ZIP w0e)