HomeMy WebLinkAboutMortgage_Greene^'�a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun T ip r
.._—
• FOR DEDUCTION FROM ASSESSED VALUATION
sr�ce r�rr.� as�oe tan i �-as)
�' � Prescn3ed M �ePartment af lnd Govemment Frwice
Fil
WS7RUCT10NS:
To be filed in person or by mad with the CowrtyAuditor or Counry Recorder o( the counry where the propeRy is located. F� � �
Filirg Dates: 1) Real PropeRy: Must file dunng the year (or which Ihe deduction is soughL Counry di
2) Mo6ile /ManWaciured Homes rrot assessed as Real Plnperty: Must file during the fwelve (12) months � gS C�1o�1 �T���O R
6e/ore March 31 of each year the deduclion rs soughG -
See raverse side for additional instrucLbns and qualifirations.
MP�p� �wrier ormnlraU 6NT+'see re5nctio2sRn revarse side)
Tatig DistriU
Name
W�Y�
-dU'
, / Contract md
wrtent year
on mmd is mflerent t7wi ihat ot app9rant, InEitata 6ebw.
s
Addrea ot mwt9a9ee w contract seuer (nurMe�entl stree4 rdy, s
Name ot assignee or othu owner or hdder of rtprtgage
Add25s of assigtree (nv:n6er arM afreet, dry, state, enE ZIP cotle)
Dces ePpliont arm property in any oNer tt yes. wh:
munry m IMiana? i-1 .,'" f�_
approved'c� tlre artwnt of.
20 _
iture of CowNAUditor
o aola "c��lD
! as of Mongage / ConvaG intlebtedne�s unpaid as d Is Ne appOpnt Ne sole
date ot apOGcation legal or ep�bWe ovmefT
�j i'es ❑ No
tt owned wiN someone ather than spo�ae, Ind'icate whh whom
Is ihe properry in question: Mnually Asse55eC
eal Proae�v 0 %���N�
Mohile Home (IC 61.1-i
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I I We certfy under the penalty of perjury Nat the above arM for•
ovmer I wntract buyer of the aforemerrtrned oroPertY on date [
a�r�
��
anE /sbeet, dry, state, arM ZIP a
. il'CI.MI$�Cii Z� ��
' of Momey w by IC E7.142-07
person (numbera�M sLee4 �Y. sbM, en0 LPaotla)
i 2QUested on
❑ Yes
zo_
dsY, l'ea�
zsident of Indiana and
day, yes�