HomeMy WebLinkAboutMortgage_Harris (5)^'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun _ Township Year
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� FOR DEDUCTION FROM ASSESSED VALUATION
' s� w�m ��ov �an i s�os>
�` ,� ? p�m'bed M�P�reN ot Local Gwemment Fuamx
File Mark
INSTRUCTIONS:
To be filed in person w 6y mai7 wifh the CourtyAUditor or Counry Recarder o/ the county where the propeAy is located. F
Poirg Dates: i) Real Property: Must fJe durirg the yearlor which the deducfion is sought. � Coun Audr r
2J Mo6Be / Manu(actumd Hortres rrot assessed as Real Property: Must fi!e during the RreAre (12J months
befae March 31 of each year the deduclion is soughG �e�
See reverse side /or additional insWcGons and qualifications. G�
Appfvarlt.(¢rrer or tonbaC buyer'see �.tX�F-�-/�B) H//��1 �
Lb 0�40if1//J �. QL
:ed ralue oF inal praprity as N
7, pvmV yYar
rllCgalae�LnPtlon ��T—�
- 3/- oo _ 6ao. a
Mortpage / ContraU Inde6te0rress unpaid as d Matgage
Ma� 1, curtem Yrar tlate o( ap
tl no, what is his / her e� share af interesY?
If namo m remrd'a 6Rerent Nan ihat ot app6�ant, trdkate bebw.
Name W mortgagee w mntract seller �
qdd2ss of matgagee w mntract se9er (num6er a L cily, stats.
Name of assignee a other wmer or hdder of rtmrtgage
Atltlras5 of atignee (numOr! aM atree; dty, state, antl LP tntle)
Does aPD��mnt wm pmperty in any other If yes, whal m
counry m Ind'aia? n va —.I—l_.i_. _— _
:�
In Ihe artaunt oY.
zo _
�/1 — I KTai Ta�d�g Distric[7
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� �n�i Cb�� pD
C-'°.�� ��,
a
Reco�d numeer
'vde6tedness unpaid� /`�
spouse,
Pa9e
v� u No
W�PenY � Vuestion: ArinuaAy Asses�.d
ealPfoPenY ❑'�^^!!��Y�
Has ihis detluction been
for w�rent yeaYl
�
�r, r�aA
O�nY
❑ No
zo _
I/ We certify under the penalty of perjury that the above and foregoing infortnation is W e and mrteU arid that the appiicant is a resident of Ind`ana and
owner I contract buyer of ihe afwementloned property on date appfication is filed. �
Si9nanue (o e/s fid/ name) Date (monN. daY. l'�/)
� � �!-2 U�,,, c� . � c� nn� / ' 7 ' /3 _
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Pason authorrzetl Ey
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(numberarN sbeet dry. sbte, and LP mUe)