HomeMy WebLinkAboutMortgage_Naas (2) L ' STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
s : FOR DEDUCTION FROM ASSESSED VALUATION �t--�
- �• State Formby 43709
Depa 1/609) Filer
E
Prescribed try Departrnerd of Loral Government Finance r
INSTRUC17ONS: 1�
b be filed in person or by mail with the County Auditor or County Recorder of the county where the property N o Y' Z m
Pe Y N ty ty P PertY is located. n'
Flag Dates: 1) Real Property.Must file during the year for which the deduction is sought. Chanty Auditor
2)Mob,le/Manufactured Homes not assessed as Real Property:Must file during the twelve(12)months
before March 31 of each year the deduction is sought , n R corder
-
for
See reverse side for additional instructions and qualifications. '�'""
GIRSON COUNTY AUDI 7 uK
(owner or contract b�� mreverse side)
T Key number/I�desorip) tion Record numt>� Page number
�tA A& — /a '07 - 3.0a -000. 59 5 -mad' ?OIII ?18 '18
Assessed value of real property as of Mortgage I Contact Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March is aarerdyear Mann 1,current year date of application legal or equitable owner?
3 Sf 0 0 0 , ❑ 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.- -4—nrooerty in question:Annually Assessed
�•n.•.,roaMAssessed
• flt 0-1.1-7)
Name of mortgagee or contract seller
513
Address of mortgagee or contract seller(number and street,city,state,and ZIP code) D I'a})_e f.
I,
U...... ......6U .
Name of assignee or other owner or holder of mortgage
Card 1\r0. .
Add of assignee(number sae&s,state,end ZIP code) / n ..... /�
T S_�F {� 4ll 7 lJ g, 7
Does applicant own property in any other If yes,what county? • What Taring District? Has this deduction been requested on property
county in lydana? for current year?
❑ No❑ Yes ❑ Yes ❑ No
t
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 20 20 20
-
Si of County Auditor County Date(month,day,year)
'gnaturAuditor
I/We certify under the penalty of perjury that the above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner l contract buyer of the aforementioned property on date application is filed. .
/ (owner's tuft name) „^ e Date(month,day,year)
rC,
Full ofa t(numbeerr andd street,aly,sastate,and ZIP code)
,/ ai 5, a Sr). Princeton TN . .
Ferson authorized by duly executed Power of Attorney tar by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code) .