HomeMy WebLinkAboutMortgage_Pfohl ,¢ C.STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS nn Township Year
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�-i ^ FOR DEDUCTION FROM ASSESSED VALUATION
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INSTRUCTIONS: .
To be filed in roman or by mall. wNi:
Fdng Dates: 1) Real Property.Must be completed and dated in the calendar year for which the deduction is sought. NOV
Must be filed or postmarked with the County Auditor or County Recorder of the county where the property is 9 County Auditor ;
located on or before January 5 of the immediately succeeding calendar year. u
2) Mobile/Manufactured Homes not assessed as Real Property.Must file with the rattlyAuditor of the _ er
where the property is located during the twelve(12)months before March 31 of each year the deduction is
See reverse side for addltkinal instnictions and qualifications. GIRSON COUNTY AUDITOR
Appfaant( 2, on ��e�/1 ,{ �Jn wm�e �J'
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IC'" a—d 1, -C1Q�057 � oo� dot/6r. /O3 .5-
vatue of rest properly as of Mortgage I Contract indebtedness unpaid as of - Mortgage/Contract" ��/u�'aid as of is the app&ant the sole
date,arrant year assessment date,arrant year data of application nrtleb[ed0 legal or equitable owner?
Jd3, /32• 44 ❑ yes 0 N
If no,what is his I her exact sham of interest? If owned with someone other than spouse,indicate with whom
If name on record is(efferent than that of appPvnt,indicate below. Is property in question:Annually Assessed
• Real Property El Annually Assessed
azioit912a0 Mobie Home(IC 6.1.1-n Nmrc of mortgagee or contract seller (;/ \
Address of mortgagee or contract seer(number and street city,state.end ZIP code)
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I If yes,slate amount of deduction/9f,
dries that is recorded in the county '
s for the deduction.
5— CD- ico
20 20
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Date(month,day,year) .
ppicard is a resident of Indiana and
Date(month,day,year)
Date(month,day,year)
Address of authorized person (number and street city,state,and ZIP code)
The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.