HomeMy WebLinkAboutMortgage_McDonald STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
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Pnesaibed by Depamnem of Load Government Finance
INSTRUCTIONS:
Form find
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located- 1 11A,E1 rll`I"J7�,lpJ ICJ
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. JU 1v County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(12)months ❑
before March 31 of each year the deduction is sought - ecorder
See reve side for additional instructions and qualifications. J 1
Appfoant rwwntractbuyer��pponreverseside) M CiOUNTY AU0170R
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Assessed value of real property ss of a I Contract indebtedness unpaid as of Mortgage I Contract indebtedness unpaid as of Is the applicant the sole
March 1,asrent year 1,aurent year date a(appgcotion legal or equitable owner?
/3_9 coo ❑ yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of applicant Indicate below: Is the property in question:Annually Assessed
❑Real Property ❑Annually Assessed
Mobile Home QC 61-1-7)
Name of mortgagee or contract seller S a
Address of mortgagee or contract seller(number and street.ray,star,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address at assignee(number and street,city.state,and ZIP code)
Does applicant own property in any other I If yes,what county? - What Tarring District? Has this deduction been requested on property .
county in Indiana? ❑ Yes ❑ No for current year? ❑ Yes ❑ No -
COUNTY AUDITOR
Deduction approved In the amount of
20 20 20 20 20 20_ 20
Signature of County Auditor • County Date(month.day,year)
/We certify u :-r the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
■ er I con•':ct buyer of the aforementioned property on date application is filed.
/j (o _Cs Ml name) Date(month,day,year)
_ 1ni --•ant address of applicant(number and sheet,ay:state,and ZIP code)
Person authorized by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,
Address of suthoraed person (number and street aty,state,and ZIP code)