HomeMy WebLinkAboutMortgage_Winstead IS
a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun ".'Qj ,I;glin
FOR DEDUCTION FROM ASSESSED VALUATION
t'. Prescribed 43709 Department nt of 6-09)
L � !
Prescribed by Department e(Lnd Government Finance
I e Mark
INSTRUCTIONS: +/
To be filed in person or mail with the Coun Auditor or County Recorder of the county where the property F..17 mad a •I
Pe by N ty N P penb'is located. Wenn.
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought.
2)Mobile/Manufactured Homes not assessed as Real P IBSON y�Ur a
raperfy:Must file during the twelve(12)monfh� ut I OR
before March 31 of each year the deduction is sought - E County Recorder
See reverse •e for additional instructions and. -litIications.
Appfoant .wnerorcontrac;buyer-see --• ... • mverspside)
/ redi
�/ Key number/legal description Record number Page number
�8 7. , � at Dc- oo - Oo/ Q 9(( a0%3 3433
4(&d vaho of real property as of i73,3_
Mortgage/Contract indebtedness unpaid as of Mortgage I Contract i debtedness unpaid as of Is the applicant the sole
March 1,current year date of appWatbn legal or equitable owM no/ -/ nI ❑ 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 property in question:Annually Assessed
Real Property ❑Annually Assessed
e/ 6e �`% �,,\\ Mobile Home(IC 61.1-7)
Name of mortgagee or contract seller
Address of mortgagee or contract seller(number and stre M.state,and P code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city state,and ZIP code)
Does applicant own property in any other If yes,what county? • What Taxing District? Has this deduction been requested on property
county in Indiana? ou
❑ Yes ❑ No for rrent year? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of •
20 20 -/�/—,�{- - 20 20
Signore of County Auditor
Ufa(5 ram /�t'l y�.-XE M Date(month,day.year)
I/We certify under the penalty of perjury th /3 9 2 /? d that the applicant is a resident of Indiana and
owner I contract buyer of the aforementiory v`�.l
Slgna, re - -xis lug name) Date(month,day,year)
S IAA AA , JALlr�s
Full resi•ent ad ress of appfront number and stn..._.,,__
7\ flit 17 00k kl g64-, Havoc-tad+, 1N Li (cY/
Person authorized by duly execrated of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of audiw'vcd person (number and street city,state,and ZIP code)