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HomeMy WebLinkAboutMortgage_Faith �a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year toFOR DEDUCTION FROM ASSESSED VALUATION r State Form C37a9(R11/6og) c SLe �� Prescribed by Department of low Government France INSTRUCTIONS: . Form Bled with lb be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. S r-©f1 (114 Filing Dates: 1) Real Property Must file during the year for which the deduction is sought. n ditor 2)Mobile/Manufactured Homes not assessed as Real Property Must Me during the twelve(12)months �I--I Court R before March 31 of each year the deduction is sought - N tY ecord • See reverse side for additional instructions and qualifications. MW Ap.. ��((ownera .. buyer-see 111 reyry�sry �� GIbi SUIN LiuUNTY AUDITOR Ke e�dewtp' O Reconl number Page number / • 7l /ooJ 97a- oat 4 ,Y ows Assessed value of real property as of Mortgage/Contrail Indebtedness unpaid as of Mortgage I Contact indebtedness unpaid as of Is the app./want the sole Marts 1:current year March 1,anent year date of application A5-9/J�� legal ❑ Yesle❑ oN tine,what Is his I 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 • eat Property ❑Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contact seller /'C Address of mortgagee or contact seller number and street,city,Sate,aaea-X.0 ode) ////^/���� Name of assignee or other owner or holder of mortgage / 2000. Address of assignee(number and street,dg:state,and VP code)Does applicant own property in any other If yes,what county? • What atAX-Z1-1-aiddzamo ? Has this deduction been requested on property county In Indiana? current ❑ Yes ❑ No for year? ❑ Yes ❑ No COUNTY AUDITOR Deduction approved In t ____._ __ 41 1 51, 5.°° 20 I _ 20 20 20 Drawer NO aelq Signature of County Au[ ,County Date(month,day,year) II We certify urde Card NO. °3 lotion is true and correct and that the applicant is a resident of Indiana and owner I contract bi filed. Signature(owners All name) _ Date(morrh,day,year) Full resid t of rtnurnber and greet illy,state,and Zl} e) Person authorized by duly exea:ed Power of Attorney or by IC 6-1.1-12-0.7 T Date(month,day,year) Address of authorized person (number and street city,state,and LP code) .