HomeMy WebLinkAboutMortgage_GressR'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count
a FOR DEDUCTION FROM ASSESSED VALUATION
.•-- " s�e F�m as�oe �n r s as>
,�+ � p�¢soiy¢d Ey DepartmeM af L.ocal Govemment Finance
INSTRUCTIONS:
To be filed in person a 6y ma�l with the CourrtyAUditor or Counry RecoNer of the county where the pmperty is located.
F7ing Dates: 1) Real Property: Must file durirg the year for which fhe deduclion is soughL
2) Mobde /Manufactured Homes rrot assessed as Real Property Must file during the tvmhre (12) months
' before March 31 of each year Ne deduction is �ht
See reversa side /a adddional insWCtbns and qual'ficat'ans.
AnNcant (owner wconhafl bure/"eee resL"ctions m reverse sifei� �-. � � i
ia�g oiso-in
A�ed vdltp
A1a(U 7. cure�
n m, vAut ls his I Mr e� shae or intemst?
�emd iv dfllerent Nan Nat ol aPpOCan[, trMirate
1�
Hame at niortgayee or mnvaa une, �
J
qddress a{ �gag¢¢ w mntrad seller (numbe� a
Name of assi�cre w othu ovmer w halder of mort9a9e
� 1 . 3I
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_ �,� �1(y(� . —
a C�rd \'O. ::....'. 0�� -
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intle6tetlne55 unpaid as a( Mc
aM ZIP code)
NTa� Taarg �aNCCt
Fam filed wtth:
NQV� 3��38t�d,�
J n(y Rewrder
C.
COUNTY AU
6teAness unpaid as d I Is �he aPW�t Ne sde
legal or equib6le ame(1
❑ Yes ❑ No
spouse. irdirate with whom
Is tl�e ProPP+�Y m Gues6on: Mnua➢Y Assessed
❑ R� �o�rty p a��y a.�a . .
requested on D�We�i'
❑ Yes ❑
— _ za_ zo_ zo_ zo_
Sigreture o1 Co�mN nu6tor . Counry Date (monN, dav. YEa� ,
I I We cerV�y under ihe penatty of pe,rjury Ihat Ne above and foregoing infortnalion is W e and corteC arM that the applirant is a resident of Indiana arM
owner I mntrad buyer of lhe aforementioned pmperry on date appiiration is filed.
Si natura fs (u0 name) Date (rtmtli. daY. Yaa�I
� �A�vr����
resident address of iPA'�nt (n ymLw.=riE st�yY, tlN state, eIM LP oode)� !/1
by OWy exewted Power of Atmmey w 6y IC 61.7-12 .7 v I�(�+w. �Y Y��
Ed pers,u� (numberand saeeG <+N. state, end LP code) .