HomeMy WebLinkAboutMortgage_Bingham (2)"��+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
• FOR DEDUCTION FROM ASSESSED VALUATION
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�TRUCTIONS: ��dd
To be fi(ed in person or by mail with the CounryAUditor or Counry Recorder ol the county where the property is loc�� 2 Fv�p� with:
Fifi Dates: 1) Real PropeRy: Must fi!e durin the ar /or which the deduction is so ht C U
ng 9 Ye �9 CountyAuditw
2) Mo6Re /Manufad�red Homes lrot assessed as Real Property: Mus1 Re dunng the hveNe (12) moqth.S. Counry Recorder
6efore March 31 0l each year the dedudion is sayht.
See �everse side for addifional instrucNons and qual�cations.
MO�P�(owrerorcontraCbyrer'�reshictiuy�nrevelmside) , n
T�g 0.strict Key number /
a -
hssessedrduedrealpm�tY�d b1
Me�d� 7. tlxm�G yPar M
II ra, whal 61tis I hu e�cl sha�e Of inteJrsi?
Name ot mort8a9ee or a
Addres of rtwrtgagee or
- a - �oa -
� / Contract Inde6te�n�
wrrenl yrar
mee4 �Y.
nartle rn�ee w mner ewner w meer v� nvcgage
pd / atsignee (numberaM street dry. siaM, anc
E �y-/-
Dces appli�nt ovm Wop�y �� eny oUer
munryminaaria? ❑ Yes ❑ No
�
Deduceon approred'e� the amount at
20 _ 20 _
_�_� / r� Y
I/ We cert'rfy urder the penalry af
owner f mntract 6uyer of the afor
� �g (owneYs hAl name)
L
�FWI resi
SS
Puson
i
OY tntle)
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It yes. what muntyt
ga_o /� � �o
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L
WhatTa�d`y D¢tric
��3A.
-(j8 U
N spouse,
Is ihP„pi
�paid as of Is ihe apPluant Ne sole
O C7 � a eQwta6ie amert
❑ Yes ❑ No
perty in ques6an: Mnualy Assessed
P(operty Q �� ASSeSSed
Dra�ver \Of.,d`�'•��••••••"
Card NO. .. �� �D...........
: � 1a3,5�-°�
2q _ 20 _ 20 _ 20 _ 20 _
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cou�ry Uate (rrnnu'. dar, r�d
the a e aM (oregoing infortnation is W e and correc[ and ihat the applicant is a resident of IMiana and
pro on date application is filed.
tent etlCress ol appaant (number arrtl5tree4 oN. ��. � LP m
I w f! �ioo N Pa.1'oKa_ .I'- �1
iuttw�aed Oy dWy exewteE Power of Atbrtiey or by IC 67.7-12-0.7
d authv¢ed Pelson (numbe� ar�d saeet �Y. sfate. arW LP mdeJ
_ _ _ �..o�i..�.'.....-o. _
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