HomeMy WebLinkAboutMortgage_Boyle (3) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS
7�-xa County Township Year
tel: FOR DEDUCTION FROM ASSESSED VALUATION lf1A \ I 1
State Forth 43709(R73/1415) �-usvn to 1
�- Prescribed by Department of Local Government Rnance J
INSTRUCTIONS: File Mark
Tb be filed in person or by mail rm filed with:
Filing Dates: 1) Real Property Must be completed and dated in the calendar year for which the deduction is sought
Must be filed or postmarked with the County Auditor or County Recorder of the count'where the property is County Auditor
located on or before January 5 of the immediately succeeding calendar year.
2) Mobile/Manufactured Homes not assessed as Real Property:Must file with the County Auditor of the county 0 Courtly Recorder
where the property is located during the twelve(12)months before March 31 of each year the deduction is sought
See reverse side for additional instructions and qualifications.
Oprigterrer or contact restrictions on resMe)1e .
T qstrict Regal desaip fir Record number Page number
Ton -12- 06-2ok-004 . a — 02-8 . ?wig Spay_ ,
Assessed value of real property as of Mortgage!Contract indebtedness unpaid as of Mortgage I Contract indebtedness Der as of Is the appr nt the sole
assessment date,current year assessment date,current year date°japplicationn �] legal o noble owner?
'h SD oo0 - Yes ❑ No
If no,what is his I her exact store of interest? If owned with none other Clan spouse,indicate with whom
If name on record is afferent than that of applicant,indicate below: s property in question:Annually Assessed
Real Property ❑ Annually Assessed
Mobile Home(IC 61.1-7)
Name of mortgagee or contact seller O1 (\ u O / T C 1 E Tf 7� .
an
Address of mortgagee or contact seller(number and street,city,state,and ZIP code) Il(� (.� ILJ I L q , T)
Name of assignee or other owner or holder of Mortgage FILET)
A I 1 CfRI 2019
O�'nJl
Address of assignee(number and street,city,state,and ZIP code) IV V J
_ L_- •=i Ii
oDoes ther applicant own properly in any If yes,what county? I What Taxing District? I can proprty roc ath CITTIO s ( ' gplgum of deduction
in Indiana?county ❑Yes ❑No — airtent veer? -0"'��Yees 0 No
IJ It
A person is not entitled to this deduction unless the 1 0 / p re L 0 0 7 febtedness that is corded in the county
recorder's office(including any home equity fine of c 0 !basis for the deduction.
Drawer NO
Deduction approved in the amount of.
20 20 2C Card NO. - 20: 20
Signature of County Auditor Date(month,day,year)
•
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
owne ct buyer of the afore ntioned property on date application is filed.
Si re(own full name 1-h.day,yea,
16-I°1
Fu e'sident ad of app and fifty s`Ja e.entry,code ' 1 ^fl
161 �� yvaOOf� 1 vIK Y itv •
Person authorized by dutyexecuted Power ofAton% r by IC 6-1.1-12-0.7 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. •