HomeMy WebLinkAboutMortgage_Martoglio a STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County iFILE.Dk Township Year
HF:,:
torFOR DEDUCTION FROM ASSESSED VALUATION
1 .� State Fond by De (R11/609)
<`�iQ^-.'J�A Presrnbed by Deparur�eN of Local Government Finance
INSTRUCTIONS: ortp�¢d •
To be filed in person or by marl with the County Auditor or County Recorder of the county where the property is located. F </!a N vy �Q{i
Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought Lr`J5. Coon )163tor
2)Mobile/Manufactured Homes not avt sled as Real Property:Must file during the twelve(12)months
before March 31 of each year the deduction is sought - .County Recorder
See reverse side for additional instructions and qualifications. G`IBSON r!
Applicant convect buyer-see resron verse ' ) ,e OUMT)'AUDI TOR
(//]/� e
, , Key number/legal desrnp' ''
Record an P n
K/„l 1. 1 . —/ - 11O- 41 • - Do' 7 I O i3`' °°�C
Assessed value of real...... as of Mortgage/Contract indebtedness unpaid as of Mortgage/ indebtedness unpaid as of Is the applicant the sole
Mash Lament year March 1,current year date of ap 1 legal or equitable owner?
id° ❑ Yes 0 No
If no,what is his/her exact share of interest? If owned with someone other than<prime,Indicate with whom
If name on record is dRerent than that of applicant,indicate below: �le property in question:Annually Assessed
pQ rReal Property ❑Annually Assessed
/�7 �'
Mobde Home(IC 6-11-7)
Name of mortgagee or contract seller
f,,y,,
Address of mortgagee or contract seller(number and
sheet city,state, LP code)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and sweet city,state,and LP code) �� r— A- 2—oz —// Z ge
Does appl'i ant own property in any other If yes,what county? . What Taxing District? Has this deduction been requested on property
county in Indiana? a
❑ Yes ❑ No for anent year? ❑ Yes ❑ No
ga 1 q UNTY AUDITOR
Deduction
20 Drawer NO•••• 0 20 20 20
*nature C Card NO. ......S—.002-. . Canty Date(mach.day,ten
I 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
Amer/contract buyer of the aforementioned property on date application is filed.
nature(owner's full name) , ,/, 'a.// Date(month,day,year)
Full ent address of applicant(n rdd sbee4 oly state,and ZIP code)
6) 9 7 N 02 75 al Pnti„ -P?„ ef., ,LA,,, 77cx
Person authored by duly executed Power of Attorney or by IC 61-1-12-0-7 Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code) .