HomeMy WebLinkAboutMortgage_Sias^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Year
_,. • FOR DEDUCTION FROM ASSESSED VALUATION
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•�' �«. � Presrnbed 7Y �epartrtcent of Laal GwemmeM F�wice
File rk
INSTRUCTIONS:
To 6e filed in person w by mad with Ne CowryAuditor or Counry Recorder o/ the counry where the pmperty is located. F� fl� �'
Filirg Dates: 1) Real Property: Must file durirg the year /or which the deduction is sought �����
2) Mobde / Manufactured Homes not assessed as Real Prnperty. Must fi!e dunng the hxelve (12) months
6e(ore March 31 oteach year the deduction is sovght. � ❑ County
I
See reverse side for additional inshucUons end qualifications.
J — ^VV� . 07 � (/�
A�ed value of mal pooperty as d 'Mortga ga / Contract trdebtedness unpaiO as of Mortgaqe / Contraa
Marth 7. ament year Marrh 1. airtent year date of appGmtion
If rq, what Is his / Mr e�mtl share of interest7 H owned wiN sonieone oNer'
If name On remrd i9 Q`flerent Uian Nat of aDP��L hbicate bebw.
Name of rtartpagee ar mntrau seller /)�� �
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aedress af mortgavee ar mno-aa sener (�+�+ara steeL cip: �1
Name W assignee w other avmer or hddu of mortgage (�
7
Atld(ess of assignee (number arid street ciry, slate, and LP oode)
Does ePPlipnt own yoperty in any dher II yes. whz
counryinlndgria? � _. � ..
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zo �a- 5���
I/N
owner I conaacz w�.,. "'._
Sipfanue( �/ �ef�s,twreme) ln/�
� /�/q�
F�ID rrsident aOAr� o7appfimnt (i
- �3��r��
Pnison wthorm.-0 by Ou7 ezecy�
Address ot auCmrrsed persa� (nw
COUNTYAUDROR
I num6et Page numbrf
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asd LslheaPP�lNe
Is,�al w equllaNe o�.neR
❑ Yes ❑ No
wiN wFwm
�e properry in QuesOo
Rea� Roaenr ❑
far current yeaR
61.
stetl m P�RY
Yes ❑ I
20 2� _ 2� _ 20 _
Caunry Date (manM. tlaY• YEa�
regoing information is We and cortect and Nat Ne applicant is a 2sident of Indiana a�
appiication is filed.
� Date (month. daY. Yaa�
iiM sbee4 dry, sbt . LP m
oflLLtmneY w by IC 61.142-0J
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