HomeMy WebLinkAboutMortgage_McKinney (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
t-, FOR DEDUCTION FROM ASSESSED VALUATION Prete Porn b (R11/609)• Prescribed by De partm ent of Local Government Finance
I D
INSTRUCTIONS:
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is(ocamA' 6 Foroly'Jey with:
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. LU❑I J County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)mont s
before March 31 of each year the deduction is sought. A - Z in; • my Recorder
See reverse side for additional instructions and qualifications. G IB SO N ant i NTY AUDITOR
AppfWan)(owner or contractb -see strrfi. on reverse side)
/�tJ0 > 7 Record
T. . .District / / Key er//o esm34 - olOO-�/, /6/ -O off- / �Oo ? Page 5/ 1-
Assessed .:areal• ..,/ as of die)
=aye/Contract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the apprxant,t the sole
March 1,amen year I MMert'h 18aurent year date of application legal or equitable owner?
/049i 00 Q ❑ Yes ❑ No
It no,what Is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name an record is different than that of applicant,indicate below Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobde Home(IC 6-1.1-7)
Name of mortgagee or contract seller /
i - - 5 • —
Address of mortgagee or contract seller in /I and save(city.state,and ZIP code) • r
• ,
Name of assignee or other owner or holder of mortgage
a� UI... -
Address of assignee(number and street,tlty,state.and ZIP code) ••.
°r _ NE 3G - d - /)- cA . 1714c. l -to..:.....
Does applicant own property in any other If yes,what county? What Taxing Dis, Yl v a\�i C • -
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countyinIndana? ❑ Yes ❑ No 31 187_•
COUNTY AUDITOR Card rp•nA ••�•/1• ryJ
Deduction approved in the amount of. I 12 h • D
•
I
20 20 20 20 20 I 20
Signature of County Auditor !^C / ■ County Date(month.day,Year)
/We We certi penalty of perjury that thee above and foregoing information is true and correct and that the applicant is a resident of Indiana and
1 - owner/contract buyer of the aforementioned ro on pplication is filed.
\ Signature(owner's IW name) .�I '�(.,� Date(month,day,year)
address n J
WI resident address of a t(number and street,city,state,and rode) •
39 5 6 S 7 o y 7 AC' S
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,and ZIP code) .