HomeMy WebLinkAboutMortgage_Whaley^�� STATEMENT OF MORTGAGE OR
_ � FOR DEDUCTION FROM ASSESf
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INSTRUCTIONS: '
To 6e hled in person or by mai7 with the CountyAuditor o� Counry Recwder o/ the �e rty is located.
Frfiig Dafes: 1) Real Property. Must file dunng the year (or which the deducfion i
2) Mobile / Manufactured Homes not assessed as Real Pru� � f�s� ' ��jfl}inonths
before March 31 o(each year the deducfion is sought. �
See reverse side lor additional instnictions a� qualifrcafions.
Ap ownerwc 6 -seeresnicnonsq� varsesede)_ /'� / 7� /�
r�� /��YY',�-�� `�`" l. /�a�t Ui u i� ��i �9 !/u/
rabrw pis 'a , Kev mmber / leaal desviotron ��
az ot � hbrtya9e / Contratt 4dPbtednes5 unpaid as of
L'J ifW
m, what
name on
Name W moRgapee w contrarl seller �
�TFCu
Address of nqrt9agce ot contraG se9er (nurtiber and sbee4 �+N. slate. ard LP mde)
Name o1 atvgnee w othrl owner ar hdder of nwrtgage
AdAress of assignea (num6eraM sVeet, tll}; state, and LP cade)
Dces eDP�innt own praperty in any oNrJ
munrylnlrWiana9 ❑ Yes
De�ucfian apprwed In Ihe atrount
�I.]
Y�.
File Mark
Fortn Ned with:
County Auditor
County Rewnder
numbel
date o( app�cation legal w eQUitable owne(1
❑ Yes ❑ No
n owned wi� someorre otlwl than spoise� md�te with whorn
is Ihe GroGP�Y in 9uesGOn: Mnually Assesse0
�Real Property ❑ Amualiyhssessed . ' '
couNrrauc
E.r F:��-u.k'. � -
7t'Y�, O� �
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D1��„���- ,��o.. ao,3 ... ..
C:ll'd l��O. ....�?!�y ........
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� G�Y
❑ No
20 _ 20 _ 20 _ 20 20 _ 20 20 _
5'rya4ue d Ca�ntb Auditw Counry Date (rronth. daY. Yea�)
I I We certify under ihe penalry of perjury Ihat Ne above and foregoing infomiation is W e and corteG and that Ne applinn[ is a resident of Indiana aM
owner I contracl buyer of the atoremerrtioned property on date appliration is filed.
Sigrm�ue jywmYS��dI name) // /i Date (mw+th. daY. Y�a�
revtlent eddresS W appOwnt (numbe�and sbee4 dty, state, arM LP
7�
.Itr_
author'¢ed person (numberand sneet aY, sbre, aM Z!P cotle) . - -
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