HomeMy WebLinkAboutMortgage_Angle Jr �. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
h';E: FOR DEDUCTION FROM ASSESSED VALUATIO $
�u' rr- Slate,bed 43709 Department/t of I F Y E 0
k��,y—'r�'9 Pn;saibed by 709(Rh ern of Local Government Finance
File Mark
INSTRUCTIONS: ++,,��
Tb be filed in person or by mail with the County Auditor or County Recorder of the mini�44 a property is located. Form filed
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought K. County Auditor
2) Mobile/Manufactured Homes not assessed as Real Property M ,,,file during the elve )months
before March 31 of each year the deduction is sought /f/ -• County Recorder
See reverse side for additional instructions and qualifications. GlBSfN COUNTY AUDITOR
Appfcant(owner or s reverse e)
L
Tatie� \UA dad / Key number /' /8 .36._ golf -000.x51/2:1' number Page number
Assessed value cf realproperty as of Mortgage/Contract ind badness unpaid as of Mortgage I Con'trar1 indebtedness unpaid as of Is the app t the sole
Mardi 1,parent year March 1,current year
J(/C/ 0O date of application legal or equitable owner?
IC ❑ Yes 0 No
If no,what's 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 ❑AnnuallyAssessed
• Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract lister 6ss �� �]
Address of mortgagee or contract lister(number and steer city,state.and ZIP code) ,/� �./ J�,!c ` , 1 1 � —
Name of assignee or other owner or holder of mortgage H U/ (�(../ �.1
Address of assignee(number and street coy,state,and ZIP code) "-'- r
Does applicant own property in any other If yes.what county? • What Tr J I'(Jj 5 J= (^
county in Indiana? 1:1 Yes ❑ No I •J
No
COUNTY AUDRI �--h�-rr Ahr`t__.
Deduction approved In the amount of: I '.F1I / Qs r-71-0 I S I f'1R G
20 I 20 20 20 �7 Vl V(7 G,\�<_ _
Signature of itor
�� `• V`i✓ Z " I. Al' County
I l We certify under the penally of perjury that the above and foregoing information t 1d
owner I contract buyer of the aforementioned property on date application is filed.
Signature(rhymes hie name) Date(month,day.year)
11Ak- h a
ult tmsident address of tuber and street ru11;state,and ZIP code)
/05 50 vrir yn'env 17 R
Person autwr¢ed by duty executed Power of Attorney or by IC 6-1.1-12-0.7 Date(month,day,year)
Address of autwtred person (number and saver city,state,and ZIP code) .