HomeMy WebLinkAboutMortgage_Irvin�
"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun 7ownship vear �
_,_ • FOR DEDUCTION PROM ASSESSED VALUATION
� s�a w� aa�os �„ i s-0s)
�� f p��'p� py p¢pa�¢�( af Local Gov¢rtiment Fuiam.e
il
INSTRUCTIONS:
To be fiied in person w 6y mad with the CountyAWitor or Counry Rewrder o/ fhe county wAere the property is bcated. F� �� �q��'�:q
Fifirg Dates: 7) Real Pmperty: Must fi!e during the year tor which fhe deduction is sought. N V� tQ,p��ty quditor
2) Mo6Ae / Manufactured Homes rrot assessed as Real Ploperty: Must fife during the M1velve (12) monfhs
6ePore March 31 of each year the deduclion is saght. C. , ounty Recorder
See reverse side for additional inshuctFOns and qualfications.
Mv�yf�»�„es conoartbuyrs-seerestrirtyr}soqrever;qufe) � , N COUNTY Allnirna
�,-�_r.
ro, what
na(ne at
Nat of
C�' µ — VV— (/V�/J. —
Mo�page / ContraG tritlehteErress unpaid az of Mongage / ConYaC
Ma� 7, curtent yrar date ot epPGfalion .
�
H owned wi� someorre oNer'
Name of mongagee of contraG Seller �� %��L(_Lil �/
Addres of martga9ce or mntrad selier num6ererd shee{ ciry, spte, aM LP cade)
Name ol assignee w dher awner w hdder ot rtprtgage ���
Atldress of assignee (number aM svee4 �+ry, state, aid LP code)
ooes epplimnt ovn, v�v�r � anr omer u res. what cmmryr
counry m Ind'ona? ❑ Yes
❑ No
COUNTY AUDITOR
amount
20 _ � 20 _ � 20 _ � 21
s'gnawre ar coimN nwau
I I We cerGfy under the penalry of perjury that the aDOVe and foregoing
owner I contrad buyer of rementloned pmperry on date applicaF
Slgnanue (a e/s
Address
6y C�Ay exewted Power of Aimrt�ey or by IC 61.7-12-0.7
red person (numberand sbeet u7: sb�& and LP code)
rress �mPaid as d Is ihe aPPlkant Me sde
kgal w equitahle amerl
❑ Yes ❑ No
ise. lnd�cate wiN whom
ie Praperty in Question: MnuallYASSessed
ReaIPfOPe�Y ❑!�14�!��Y�...
s�v�, �E��y �
m�y 2
1�--� u� c�
v• i
f // /�
requested m P�P�Y
❑ Yes ❑ No
20 _
yxa�
dent of I�fana ard
;yea�
�Y• Y��