HomeMy WebLinkAboutMortgage_Gardner"'n STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Tovmship Year �
_ • FOR DEDUCTION FROM ASSESSED VALUATION
" srace wm� as�oe (Rn i s-os�
� � p�¢srn'bed by Departmen[ of Lnd Govemment Franca
���� File Mark
lNSTRUCTIONS:
To be filed in person w by ma�l with the CowlyAWiWr or Counry Recorder o/ the cnunry where the property is bcated �� �
Fi7irg Dates: 1) Real Property: Must fi!e dunrg the year (or which the deducfion is soughL . ': eu/� or
2J Mo6de / ManuFaclumd Hwnes rrot assessed az Real Property: Musf fife dunng the hvefve (12J rtronths
before March 31 ot each year the deduction is sought. County Recorder
See reverse side fur adUitional instrucfions arM quelifications.
Aoofranl (o�merw mMraG b - see res7rirL'wa on reversesidel _ /1. .
rehie d real property as d
Martl� 1. ament yPar
tl ro, whal Is hts I Irer erad share Of interest?
tl`wne m Rcortl is dMvlent Van that of app6�
Name of moRgagee w conVaU seller
AEdres ot morvpgee a oontraa sener (numbe
Name af assi9nee or othrl owner or hdder of m
street �1ry:state�
- .ID'/ J- VV -.,µ
age / Conbau 4debtedness unpaid as at Mwigage / CantraY uWebtedness unpaid as d Is Ne apPfimnt Ne sole
i rte^n�t Yrea� dare af aPP�ntiai legal a M�itaWe amerl
� `_/ _/��� ❑ Yes ❑ No
I�
'�� . r. �� u�..
i�
�qnq�
Jimnt own property in any oNP• �
Indvria? ❑ Yes . I •• • •
p,��"���� �o.... b..
D�ucGOn approvad In Ihe amount of.
20 _ 20 _
SigiqWre at Camry Auditor
la4 • fp
��l � �o. • � a3o, �yy. =
� 20
spoise,
ts me propem� m quesrion: nmuaM assessea
� Real P(Operty Q Amtually ASSeAed
Has �hs detluCion been
����
20
day,yea�
P�P�h
20 _
I I We certity under ihe penaity of perjury that the above and toregoing infortnalion is We and correct arM that ihe applinnt is a resident of Indiana and
owner I con4act buyer of the �tioned property on dale appiiration is filed.
nnnre f h� rm 1 Date (rronM. daY. Yge�
(number arM sheet, v17, state, aM LP ootle)
Date (rtronfh.
af aWhoraed Dnson (number antl sbeeS �: stafi. aM ZIP code)