HomeMy WebLinkAboutMortgage_Sinkhorn^'+ STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year �
.� _--
_ FOR DEDUCTION FROM ASSESSED VALUATION
srace Fom, aa�oe �n i s-0s�
�' ,,,, � aresrnroea br oeparmrent uf Low Gavemment Frw�ce
File Mark
INSTRUCTIONS:
To be fiied in person of by mail with the CourttyAuditor or Counry Recorder o/ the county where the propeAy is Iocated. F ��'
FiRrg Dates: 1) Real Pmperty: Must fi!e durirg the year /or which fhe deduction is sought. � q� �
2) Mobde /Manu/actured Homes not assessed as Real Pruperfy: Must fiie dunng the hveHe (12) months
be(ore March 31 of each year Me deduclion is soughG ❑ Counry Recorder
See ,everse side for additional instruUrons and qualificalions. (�
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Key number / legal desaiption
� -1�-i c_ �nn -�n
AR¢sed rdlue d real property as ot
MaU 1. amerrt �rar
rc �o, �� � na i ne� � y,� or �,��n
name on
W mortgagee or mntrarl se0er
appGranl,'vMidte below.
Addtess of rtwrtgagee or mntract seller (numbel aM
Name a1 assignee ot oMer ommer or hdder of mMgaga
Adtlress of asa�nee (number arrd sveet �: state. arW LP m���
oces eppfnnt wm property In any ov
county in IrWiara?
❑ Yes
DeOuction approved'u� ihe amount of:
zo_ zo_
9gnanrte d Crnn:b aiddor
K O v-'
Morigage / Contract i�Mebtedness unpeid as M Is Ne epp�nt the sole
datc of app�otion legal ar eQultaGe uwrierl
❑ Yes ❑ No
mmeone oNer than spo�ae, indirata wflh whom
ao ► a ... —
Dra�i�cr NO ................ —
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............
C�TCi \�. .�•�� �p .—
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Is ihe propeny in question: MnueM AssessM
❑ Real RoPertY ❑ Mnually Assessed
fat Wrtenl yeaR
20 _
sted m property
Yes ❑ No
Date (�. daY. Y��
zo
I I We certify u`Wer the penalry of perjury that ihe above and foregoing intortnation is We and cortect and that Ne applirant is a resideni of Indiana aM
owner I mntract 6uyer of the aforemendoned property on date application is filed.
�rewre (°.mre//s fu� ^ame) � n /1 � Date (nmtlt. daY• 1'e�/)
FA
Pawer of ACart�ey or by IC
ot auC�aaed persw� (numberaiN sbee; tily, state,