HomeMy WebLinkAboutMortgage_Rexing (4)""�0 STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS o hi vear
_. � FOR DEDUCTION FROM ASSESSED VALUATION
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S r Prrsrn'bea q Devartr�r� ol �ow cmemment Frerce
ur
F� e Mark
INSTRUCTIONS:
To be filed in erson or by mail with the Coun Auditor or Coun Rewlder of the coun where the ro F � '
P �Y b N P PertY is located�/
FAirg Dates: 1) Real Pmperty: Must file during the year /or which the deducfion is soughG �.,j�IP�1 d�
2) MabAe /Manu/actured Horrres lrot assessed as Real Property: Must fife dunng the tvrefve (f��g��) CO N A�
betorn March 31 of each year Ne deducbon is sought. Counry Recorder
See reverse sida kr additiona! instruclions and qualificalions.
I Ma� (owner w wnt+aU byrer'see reshicbons on rererse side)
1 1 nv. no d 1 dr �=i,,. . n o� Q„ 1._,. _
o�su�a
r.'r'�u- J
If N. Whd1 IS h15 / h¢f 010Q:h3IC 01 V1f2fE5l?
arrent year
rtwrtgagea w contracl seller (number and streef, cAj; st
signee w othel awner or tqldu at rtortgage
assignee (number and stree4 dry, state, and LP cade)
duanl orm ptaperly N
Indare?
1'l--',.?
�
R�x��� pou��� �
S A y Et�c-e D
I I-3y�/
yes. wha[ count�/1 � W�at Tapfg D'¢trict?
Reco(a
6eedness unpaid as af I Is Ihe eppllont the sole
legal or equitable owneR
❑ Yes ❑ No
S�Ip158. pIdIC9t2 �M�}i1 W110T
n quesron: Mnualty Assessed
.4rui A55essed
� MoWle�Fbme (IC 61.
Has Nk Eedutlion Deen reQUested m 7�P�Y
kr arrerrt Year' ❑ Yes ❑ No
COUNTY AUDITOR
De�uctlan approved In Me artwnt of. -
20 _ 20 _ 20 _ 20 _ 20 _ 20 20 _
SigreMe U Camb AuEltor � Caunry �aie (maW. daY. Ypa�)
I/ We certify under Ne penatty of perjury ihat Ne above and foregoing intortnalion is W e and corteU and ihat Ne applirant is a resident of Indiana arW
owner I wntrad buyer of Ne aforementioned property on date application is filed.
re (o N➢name) Date (monRt, day, yeer)
'Oent aGtlr� ol appGrant (wmber shee4 dty LPCOtle)
autho�aed by OWy exeated Pawer dAimmeY � q' IC G7.1-12-0.7 Date (rtpnM. day, yee�
Pddress ot authw¢ed Ge�� (numberar�tl sbeeL �N. stat0. a� Z!P wde) .