HomeMy WebLinkAboutMortgage_Wilkison (7) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS n Township Year
ki FOR DEDUCTION FROM ASSESSED VALUATION 4 t
'. State Farts 43709(R13 t 10.15) iy�
Prescribed by Department of Local Government Finance
INSTRUCTIONS: File Mark
Tobenedin person orbymay. NOV 30 2016 Forth
Fling Dates: 1) Real Property:Must be completed and dated in the calendar year for which the deduction is sought.
Must be Sled or postmarked wit h the County Auditor or County Recorder of the at:, , . i;t_i�- •roperty is County Auditor ,
located on or before January 5 of the immediately succeeding calendar year. air, :jri111h ❑ County Recorder
2) Mobile I Manufactured Homes not assessed as Real Property.'Must file with • r•467,}.,itpngF�libQ rdy
where the property is located during the twelve(12)months before MatFJI®fag It, -deduction is sought
See reverse side for additional instructions and qualifications. (Ida/l /�/1 (ly(�
Applicant(owrrer ^Cp /1 ` )3 I\'y�( 1 iv a ��`�"'t�3
T�\�J-)"' \Il�('l, / number? (\also -a�aoo'-000•sia-act - do Page 41758
Assessed value Kraal properly as d Mortgage I Contrail bdebtedness unpaid as of . I Contract indebtedness rmpaid as of Is the applicant the sole
>� �35611°n040-0 legal or equlable cwner?
assessment Bats,currant year ❑ Yes ❑ No
•
If no,what is his I her exact share of interest? If owned with s meone/tot er than spouse,indicate with whom
If name an record is(Efferent than that of apprxant,indicate below: Is the property in question:Annually Assessed
❑ Real Property ❑ Amwafly Assessed
(���� Montle Home(IC 6-1.1-7)
Nam of mortgagee or contrail setter __f-"
A� \\A.WheNG,S A • 01 1 -\St u' i Vie,and ZIP code)
Mai al LIv.1� 1-- 1\k-lSOV� \o •
- ll, 7 a�� Sfia- � �� • .•
Add $ -1c�
Solboo. bo Da1C `I lS�s
Dave ice,ant own property in any If yes.what county? - What Taxing District? Has this deduction been requested if yes,state amount of deduction
ion IInndiaay? ❑Yes 0 N current? ❑Yes 0 No
A person is not entitled to this deduction unless the person has a balance on the person's mo gage or contract indebtedness that is recorded in the county
recorder's office(including any home equtTy fine of credit that is recorded in the county recorder's office)that is the basis for the deduction.
COUNTY AUDITOR " - .
Deduction approved in the amount of:
20 20 20 20 20 20 20
. .....jdoacik_
Signature of I County Date(month,day,)far)
II We certify under the penalty of perjury that the above and foregoing information is this and correct and that the applicant is a resident of Indiana and
owner I contract buyer of the aforementioned property on date application is fled.
( _ hig nname�(//ii ���`ahro,'''� Date(month,day,year)
Full r \o(apjtmnt�/ (numberr� end sheet,city,sate,and ZIP code) n 01-n-1 aj.(yq acid cess— Op Q �SS�
b KK3S 9 &. 2615 84 Ki%t N Y76,Y7 _1
Person authorized by duly executed Power of Attorney or by IC 6-4.1-12-0.7 t Date(month,day,year)
Address of authorized person (number and street,d1:sale,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.