HomeMy WebLinkAboutMortgage_Wolfe"�n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Count
: FOR DEDUCTION FROM ASSESSED VALUATION
. . s�ace rorrm as�os (ai i i�os>
S,,,, : p,esa,tea br oec�m or Lod coremmem Fwrce
INSTRUCTIONS:
To 6e filed in person or by mai7 with the CountyAWitor orCounry Recarder o/ the county where the property is bcated.
Ftiir�g Dates: i) Real Property: Must fi!e dunng fhe year for which the deducUon is sought.
2) Mo6Ae /Manu(actured Homes rrot assessed es Real Property. M�st fife dunng fhe (vmNe (12J months
before March 31 af each year the deduction is sough[.
See reverse side for addlttional insWctnons a qualifications.
Ap/y�/ t ^ ortonln/dQ4vyer�-/see� nonyL /�j�� �s{N+e)
\ I // i�� (-i i" //�r/U.(�1� 1�0/ .�J 1
P�`/
-o� — ��O �U�0.3. U��7—Q/
�/ Contrau 4debteEness unpaid as of Mortgaga I Crn' e
arrent year date of ep�G�'ar��
Ii M. W�13I �5 �115 i i1Cf CX3fI:l13fC OI NICfESL!
tt n2T2 on lecWO 6 NReJPnt th3�f N91 of aGP��t 6Mi(itC 6CIOw:
Nam¢ofmory�agee«conVaGSeller ' / "
7
Address ot mortgagce w oontract se0er (nurtiber nd . cily, stafe.
Name of assi�ee w Wher owner or hdder at mo e
AdCress ot atsignce (numbar arM svee4 Gry �e, ard LP cade)
�
Does appli�nt ovm property in any oNer If yes, what ¢
counryinln0iara? n ..__ I-1 .�_
Deducnm
20 _ I 20 _ I 20 _ I
Sig�anne W Coimb N�tlitar
I I We certify under �he penatty of perjury Nat ihe above and fore
owner I wntracl buyer of the aforeme�oned property on date a�
� Fu0 rnsid
X �s_.
Address
N appli�ant (numher aM stree4 tlty, state, arM LP ca
: . ,1��� I�p �o�/�
EWy executed Power ol AltOmey or by IC 61.1-72-0.7
person (numberand sbeeG ciry, state, arM LP catle)
Cd�l11:Y�/
Counry Aud'rtor
DE �038,����
�, �n� �
dtahle amdl
Yes ❑ No
PraPenl' in 9uestion: MnuaP/ Assessed
=d1 ProP�Y � ?!?�!�.N.�
f�'' — v '/. 3a `� �
Tadfg Districl? Has Nis Eedudion Eee� requestetl on property
for anmt Y�n n Yes ❑ No
—�4—_ � 20__� 20_ 20_
� 50, $�% �� h. day ke�
DI"1\Ver NO.. �O.I:.1..,.., aresidentoflnd�anaand
• , . h, day, yea� �
_ /
Card NO. ..... . �.7..% �
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Oata (rtronN, tlaY. YEe�
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