HomeMy WebLinkAboutMortgage_Mann (2) .a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
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CFOR DEDUCTION FROM ASSESSED VALUATION
_ .�; U State Fans 43709(R /6-09)
Prescribed by Department of Local Government Finance Ild n
File SL,
INSTRUC77ONS:
F. 17" 3 Ta be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. 3 2014
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought II 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 - e17, Co ,u ""'0-
See reverse side for additional instructions and qualifications. COUNTY d
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Assessed value of real property as of Mortgage I Contract indebtedness unpaid as of Mortgage I Contract rode unpaid as of Is the applcant the sole
Mardi Lament year Martin 1,omens year data of appFuatort � /n, legal or equitable owner?
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.=J "op ❑ Yes ❑ No
If no,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 aper:ant.Indicate below: Is property in question:Annually Assessed
Real Property ❑AmwallyAssessed
Mobile Home(IC 6-1.1-7)
Name of mortgagee or contract seller /I /Q /y )
Address of mortgagee or contract seller(number and street,city,sale,and ZIP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number ands Bet,city,stale,and ZIP code) �� / //'
mss/ �_3�I 30 -,5 _/0
Does applicant own property in any other If yes,what county? • What Taxing District? I Has this deduction been requested on property
county m current Indiana? 0 No year?
❑ Yes ❑ yes ❑ NO
COUNT�Y�A�{}(J,QROR �/ - i f�A / , ( /�S'j
Deduction approved in the amount of. �/f (/ ,/uU�i�, R� (J7�-�� 1\/ �(
20 20 20 YW� -7.rte !JC -Ka L ? yJC- a / 20
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�a......r r.....»..s..cw- . . _ County Date(month,day,year)
t-vc LQ-Q-Q. &'te-IfCL 0
I I V `f �1 t� ng information is true and correct and that the applicant is a resident of Indiana and
own •'r*_ Jr��'/O / ation is filed.
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Drawer NO...c0QI 'I Date(month,day.year)
lc Card NO. 191 r,j 117632
Date(=rah,day,year)
•
Address of authorized person (number and street,city state,and ZIP Dade)