HomeMy WebLinkAboutMortgage_Sisk (6) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS 0111 � t�s Year
FOR DEDUCTION FROM ASSESSED VALUATION �-1
> b:- State Fonn 93709(R11/6-a) JL/
Prescobed by Depamned of Local Government Finanra 11 p O r- f�
tk
INSTRUCTIONS: MAR ` "' - - -- -
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Faro mad with:Filing Dates: 1) Real Property:Must file during the year for which the deduction is sought M . •Auditor
2)Mobile/Manufactured Homes not assessed as Real Property Must file during the twelve(j2J n ic'iii_.
before March 31 of each year the deduction is sought uSON C OUN A i ITO Record er
See reverse side for additional instructions and qualifications.
(owner or contract buyer see restpetiass on re side)
;Deg Wet Key number legal d Record number P um
A oleo - II- io - dao -ooy.ii3 _o,8 AciS 'l.
Assessed value of real property as of Mortgage/Contract indebtedness unpaid as of Mortgage/Contact indebtedness unpaid as of Is the applicant the sole
Mardi Laurent year March 1,current year date of application ,— legal or equitable owner?
/et/ � S.5 ❑ Yes ❑ No
If no,what Is his/her exact share of interest? If owned with someone lithe(than space,indicate with whom
If name on record is dfierent than that of applicant Indicate below. Is the property in question:Annually Assessed
❑Real Property ❑AnnualyAssessed
Mobile Home(IC 6-1.1-7)
Name of Agee or cont-ad seller
Address of mortgagee or contract seller(number and street city state,and ZIP code)
Name of assignee or other owner or holder of mortgage J—D.,-. a.0\'S — _
Address of assignee(number and street city,state,and ZIP code) Drawer NO (37015 - S'
Does applicant own property in any other If yes,what county? • What Taxing DistriC B' I a I ?-tZ S .O 0 10 q Q .
county in Indiana?
0 Yes ❑ No J
Card NO.
COUNTY AUDITOR OS n t,(4. A. S 1 S K
Deduction approved in the amount of: -
20 20 20 20 20 20 20
Sigriaua� County Date(rrimflr,day year)
I I We certify under the pens ty of of above and foregoing information is true and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is filed.
fill me Date(month,day.year)
f3/a/Lou
F t of applicant(num d street atl:state,and LP code) c
3330 (t) �� G Y74, ?-e
Person authorized by duly executed Power of Attorney or by IC G -12-0.7 Date(month,day,year)
Address of authorized person (number and street,city,state,end ZIP code)