HomeMy WebLinkAboutMortgage_Reising"'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 7 vear
� FOR DEDUCTION FROM ASSESSED VALUATION
�• Sfah Fam 93709 (R77 / 649) •
�` ,w pi¢srnbeC Ey Department ot Lacai Govemment Fitarica
Fil Mark
lNSTRUCT70NS: DE
To be filed in rson w b mail with the Coun Auditor or Coun Recorder o/ the ooun whe2 the io F� ��
PQ Y b b h P PertY is bcated.
Fifirg Dates: 7) Real Pmper(y Mus[ fi/e during the year tor which the deduction is soughL C- . nty Auditor
2) Mobile / Manufactured Homes not assessed as Real Pmperty: Must file dunng the fweNe (12) monfhs
betore Marth 31 01 each year the deduction is sought. C Remrder
See 2verse side (or additional instructions and qualifications. GIBSON
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1. firrerrt ym
If ra. what's Ids / hu e� share a( intefest?
1f name on remrd'a 6fteratl than ihat o( aPpGrant md'x
Name ot rtwrtgagee « mntraG seller
ACdress of mortga9ee w mntract seUer (n 6ei erid sP
Name M assignee w oMer owner or Iwlder of mortgage
PdAress of assignee (numDer antl streeG �riy. state. ana
Daes applicant orm property in any other
counry in IMana? ❑ Yes ❑ No
Orduc6on approued'ui the amount of.
_ � 2� � �—
HuOitOr
��
/ ContraG h
arrent year
Udl�. .3 � `%- da
5� �R�'6� o �
ss unpaid az d Mwtgage / ContrafY uWebtetlness �mpaid as d Is the a�
tlate of aPPOCatim . �. � . k9al a
�4 CiN, sbte. and ZIP code)
y
IP code)
yw. what munry.+
COUNTY
20 —
I/ We ceNfy under the penalry of perjury that Ne aGOVe ai
owner I[ontract buyer of Ne a�oremenlione� property on �
�fah�re (ownu5 G�neme� � — � - �
lly3� �� I5� t
Pe�mn auNOrizeC Gy dWy executeC
aM
142-07
Add2ss of authm'ved pert,on (numDer arM wee; dry. state, aM LP code)
20
w i— � —
NTat Ta�drg DislriG7
4UDROR
_ 20 _
Yes LI No
,�Is V�PQnY in OuesUm: MnuaOy AsscsSeE
Real Roperty Q Mnually As�sed
Has Uis dedu�3ion Deen reQUested m p'aperty
ro� a,�� y�a n.,_ _ n
20 -�
Dra���er \iO...�� I.O ....
�yo
Card NO . .....................
•�1�3,�00e°"
it is a resident of Indiana and
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