HomeMy WebLinkAboutMortgage_Papal�-�*;; STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
-°E._ = FOR DEDUCTION FROM ASSESSED VALUATION
' �r State Fortn <3709 (R71 16-09)
��• Prexn0e0 �y DepaNrent of Local Gwemmem Finarxe
INSTRUCTiONS:
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To be fi(ed in person or by maiL For�n fu �"^t "
r'iling Dat�s: 1J Real Properry: Mus7 be completed and dared in (he calendar year for which the deduction is sought.
Must be Tled with the County Audiror or County Recorder of the crounty where fhe pmpery is Io��.ON � �'�'��
on or be%re January 5 of the immediatety succeeding calendar yeai. Counly Recorder
2) Mobile /Manufactured Nomes not assessed as Real Property: Must file with the CountyAuditor ot fhe
crounry where the pmpeay is located dunng the twelve (12) monihs belore March 31 07 each year the
deducUon rs sought.
See reverse side fo� additional instructions and quafifiwfrons.
App6ant �owner or cnrY✓aC Duye(- see reSLicDms al 2ve.5e side)
Joshua C. Papale Sr.
Ta<ingDis[nct Keynumber/leqal0esaiDtim RecofcnumDer °a9'^��nstrun Ilt
Ft. Branch 2frt&73-402-000.174-026 ���-- � �OfiM EEO
AssesseE rdlue d real pfopeny as o: Mortgage / Con•.ract intlebtetlnessvnpai�'as of Mongage / Comra� indebtedness unpaitl as of Is Ne applican: fhe sole
Mar„h 1, qureni year Marcn 1, wTent year - '— tlate of app6n:ion legal or equilahle owneR
57,400 71,326 ❑O Yes ❑ No
If no, what is N5 / her ezaU share of in�erest? m owrti.0 wi:h someone oTer Nan spouse, indirate wd� whom
If name on remrd is tli5erent Ihan that W apptitant,'uWicate bebw: Is ihe O�Perty in questbn: MnualtyAssessed
Q Real Pmperry Q MnuaiyAssessed
Mobile Home pC 67.1-7)
Name ot mongagee or mnVaG seller
Welis Fargo Bank, N.A.
Pdtlress ot rtronr}gee or conlraG seUer (nurnDer antl ureel. ary. s:afe, antl ZIP cotle)
2650 Welis Fargo Way, 3rd Fioor, Minneapolis, MN 55467
Name ol assi9nee or other ow�rer p holder o( mwlgage
Pddress of assi9nee (number entl street, ary. sare. and ZIP wde)
Does app5qm oxn pmpe .ry in arry o;her 1f yes, what counry? Wha1 Tariry Dis'uict? Has �is tledudion been repuested m�xoperty
coun,y in Intliana? fw curtent yeaR
❑ Yes � No ❑ Yes ❑ No
COUNTY AUDROR
DeduUion approved in the amourtl oE:
20 2Q 20 _ 20 _ 20 _ 20 20
Sgnature of CounryAUditor Counry Date (mon:h, tlay, yea�
I/ We certify u�er the penalty ot perjury that fie above and foregoing infortralion is vue and correG and that the appliwn, is a resident of Indiana and
owner / contraci er of the aiwementioned property on date application is filed.
Signature (av 7u0 na � Date (monL3, Cay. yea�
0 2/2 7 120 7 3
FWI 2' eN address of appticant (number slreeC �Y, ��e. and ZIP cotle)
30 N. Main Si. Ft_ Branch, IN 47648
Person aWhoreeC by dWY ezeaneC Po«a of Httomey or 5y IC 6t.t-12-0 7 Da;e (mon;h. CaY. yea�
Adtlress ot au�or¢etl perwn (nvmber and screef. ciry. staR. and ZIP code)