HomeMy WebLinkAboutMortgage_Garrison „ ,?,• STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year
\$
' File Mark
To be filed in person or by mail. ' • F, fit-•with:
Filing Dates: 1) Real Property.Must be complete•!(:nd a s-• (' ; •#y t4 den --ex i G e,,C•irk':',-o 'tight
Must be filed or postmarked with 'Tam✓ u 1� re. tar#Z;( outr - • der•ii e 4•u w*;re the property is ►i County Auditor
located on or before January 5 of the immedra-I' - ed ig•--Ten►.r =rr • County Recorder
2) Mobile/Manufactured Homes not assessed as Real Property: 'ust -th? eta;, iy ' ditor of the county
where the property is located during the twelve{12)months before March 31 of each year I e deduction is sought
See rave side for additional instructions and qualifications.
Applicant w r or ntract buyer restrictigns on re rse side)
Y1 CA'Y1nsq1
Taxing District. ey number/legal description Record number Page number
vNAe _ %)-17--0 9 -401 -0 o. a 2r022 jO t 525 2
Assessed value of real property as of Mortgage!Contract indebtedness unpaid as of Mortgage!Contract indebtedness unpaid as of Is the ap I' nt the sole
assessment date,current year assessment date,current year date of pplici) legal-ore stable owner?
�� Yes El
If no,what is his/her exact share of interest? If owned with s mebne otheithan spouse,indicate with whom
If name on record is different than that of applicant,indicate below: I - e property in question:Annually Assessed
/,,i Real Property 0 AnnuallyAssessed
Ai
-- Mobile Home(IC 6-1.1-7)
Name of mortgagee o contract seller) s` �
• _ \ oWy �* • F 1 -
Address of mortgagee or contract seller(number and street city,state,and ZIP'sede)
Name of assignee or other owner or holder of mortgage
DEC-2 7 2019
Address of assignee(number and sti 5 ot c�
- 9 d COUNTY AUDITOR
Does applicant own property in any r S
other county Drawer NO 'ro��edrty�ction•--nrequested If yes,state amount of deduction
in Indiana? ❑Yes No - 'ent year?❑ r R t es ❑No
A person is not entitled to this ded )rtgage . cunt- t indebtedness that is recorded in the county
recorder's office(including any ho. Card N O• ler's office)that is the basis for the deduction.
'_ JUN I T AUUI I VR
Deduction approved in the amount of
•
20 20 20 20 20 ' 20' 20
Signature of Cow;;If ditor, County • \ Date(month,day,year)
I Vfl ( rita s� 11 2.9-..91/We certify u°I'•er the penalty of peg • -`- the above and foregoing information is tnd correct and that the applicant is a resident of Indiana and
owner!contract buyer of the aforementioned property on date application is filed.
Signa r (owner's full name) Date t nt,day, e�
�/�,� athodul:1/4_,
1�
F side its of r nt(numb nd sheet city,state,and ZIP code) ~
=402 sO si, a ,pc -fir,
Person authorized by duly executed Power of Attom y gi•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. .