HomeMy WebLinkAboutMortgage_Richardt"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun
:,--
: FOR DEDUCTION FROM ASSESSED VALUATION
' sra�e Form as�os �n i s-os�
� S ✓ p�¢�3¢p by pepartment of Local Gavemment Frwice
�TRUCTIONS:
- To be filed in person or by maB with the CountyAudiror or Counry Recorder o/ the wunty where lhe propery is located.
Filing Da[es: 1) Real Pmperty: Must file dunng the year for whic7� the deduction is soughf.
2J MobRe /ManWacfured Homes rrot assessed as Real P/nperty: Must file during the fwefve (12) months D)
6etore March 31 of each year fhe deduUion is sayht.
Sea reverse side /oradd'tional instrucUons arM qualifiptions. C.
Ap t(mmerwcontraCbuyer-seereshiraonsanrcversesiee) .
- �„ _
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rc ro, wnac 5 na � ner e�tl snare or mteresn
tt name m �emd is 611gmt Nan Nat of aDP��t mLUate Delow
Name of mortgagee or contrau
naa�ess or morteayee or m�o-a
sfree4
� CounryAuditnr
�] �ry Recorder
'_'_._.._.__ -_°_ -" -
�_�oo-ool. �6�-00/ � ' lo3t3�
act Intlehtednrss unPaid as of MMgage I Contract (n0ebcedness unpaid a of Is Ne aDDOnnt Iha sde
year date of aP�p � I�al w eWitaWe ovm�l
CoD DO O ❑ Yes ❑ No
tt ovmed wi� someona oNer than spouse, IMiqte Wih whom
Is praperryinquesron:Mnua�yASSessed
� Real PrcpertY ❑ Nmua�ly Asse�d _ ' _
Name oi azsignnee w oNer ovmet or �dtler oi mortgage
Atltlress ot ass9nee (number aM stree4 ary. sla:e, and ZIP cade)
PT r� Nw r�w �- -
Does aPplimnt own praperty in any olher If yes, what munl�R
munry m Ind'ena7 ❑ Y�
❑ No
,
� COUI
pe�uction epproved In Cre amount af.
20 20 20 20
S/
VJhatTaprg 0¢h
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I��l�� �1� I��ES1��-1 C3
�� m
1 ��-(031 �
�_ � 20_
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sgrenae N Coimb Audiwr I Counry I Date (month daY• yea�
I I We certify under the penatty oi perjury that the above arM foregoing infortnation is true and cortecf and that the appliqnt is a resident of Indiana and
owner I mntracl buyer of the aforementioned pmperty o� date application is iiled.
F�A re9dent e0tlress of apput�ant (num�er ana sbee4 tiry, state, elie LP oode)
8SS8' S. s'So � E/be�-f� ,b/ I/V y7(c /3
Person auU�wrzeO by duy executed Pw�er of Atmrt�ey w Cy IC G7.1-12-0.7
Address af au4�uvM person (number arM sbee; cdy, stala, entl LP mde)
� c�.
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