HomeMy WebLinkAboutMortgage_Jones (7) �t,.a. . STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
FOR DEDUCTION FROM ASSESSED VALUATION
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FILE ki�,-[j'%. State nil by Department of Leal Government Finance
INSTRUCTIONS: f/ed
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. D MN tti't4
Filing Dates: 1) Real Property Must file during the year for which the deduction is sought ❑ County Auditor
2)Mobile/Manufectured Homes not assessed as Real Property Must Re during the twelve(12)months ■
before March 31 of each year the deduction is sought l '•' 'ex
•
See reverse side for additional instructions and qua lifications. (;IAC(1N f:(111NTY AtIBIT[1R
Ap. -ti• owner or contract buyer-see resfi^ on reverse side) J
& d G am 7v1 4 enet ee 1
T. District / Key number/legal description / number Page number
I`, 4 r a(Q ■ 01 .7- /A - dot - ooa. I .1 .3 - 0 a_ Y `molt( 5253
-.vabie of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March Lanni year March 1,current year date of azslicatian legal or equitable owner?
?. c 100 ❑ yes ❑ No
tf no,what's his f her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is different than that of apolean/.Indicate below. Is to property in question:Annually Assessed
Name of mortgagee mortgagee agee or contract Belle` 's 3 RETIRE WITH IN
Address of mortgagee or contract seller(number and street city.state,and ZIP code)
Name of assignee or other owner or holder of mortgage
cab Ott - 5`��5r
Address of assignee(number and sheet city,state,and ZIP code) O 7` — •441. Pr Nw 5/J Id - W- 1/ /• 2794 , \`
Does applicant own property in any other If yes.what county? • 1 ()p._y )t ®�}�,t.-1-
muntyconlnd'ara? ❑ Yes ❑ No 1 4 • / �
s_. _ 3
COUNTY. < -411 T• c
Deduction approved in the amount at 1� TI'y!I
3 O �`�i r0
20 20 20 20 4 �-y 19� gin,, Ohc t
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Siena w of County Astor• OC !
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
comer I contract buyer of the aforementioned property on date application is filed.
k m
agnate NB Date(mesh,day,year)
W resident address of appt (number and sheet o175 flute,and ZIP code)
11534 S(So W 1a l3S 4/in 47639
Person authorized by duty executed Power of Atomey or by IC'61.1-12-0.7 Date(month,day,year)
Address of authorized person (number and sheet city,state,and ZIP code) .