HomeMy WebLinkAboutMortgage_McKannan (5) STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS r County Township,...---17 Year -1
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/!..i.-4, 1',. FOR DEDUCTION FROM ASSESSED VALUATION , c
Stu',.Fotrr-43,09(.14 I 1-20) i Gibson OZ))
: 2020
Prescribed bi Department of Local Government Finance
----...i --- File Mark
INSTRUCTIONS To be fred in person or by meil.
porn,fi!ede,th
Fitina Date Form MLISt be completed and dated in the calendar year for v.17ii.,-h the deduction is sought
I V', County Aud,to,
Mast be filed or postmarked with the County Auditor or County Recorder of the county where the property is •I --
located or or before January 5 o,the caiendar year in which the property
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Key nddtbe.,f lia, devit...,-D,,_' t Do , cor-d n Arrbe.':-''-''
79-+......00y- Re2-cp
---,,.s;::, ,,,i„L„:st rea'prcee di, as c.` ,Vootgage i Coo.rabt indiettedness'..:7--,a Z.:as o ,Moo:dale/Con mcebtedhess u as of 1 is t i-,.9,--',t>pt7-- "tt.,-;:t.,-7-;,;,------,
assessmeot date C,Te7;yea- assessment date current yea,- 'date . , . ' n i leaa'ot- rt 7.a.-'die' -o..Z:....;r?
I ' 372_,)---- 00 0 ( Yes n'No i
If no, eliratisTrs!he. exact Sac of tntedezt? I o.i th sa reore other than spa.ise indicate eZIC whom
If T-te:---.e oiTreigdiTtrs d ffereot Ca tt ha!of aDp,:ant ir d:ate be!ci.t. - --- --- --- 11 a property In g,teshnn if,H,Jal'y Assed-------I
i V
Rea,Property t_11 Annually Assessed
Mobile Home(IC 6-1 1-7)
i N0.0,-e ot. .g gee of cont-aot siel:er
./ state.and Z i P cr-isal: A.. ,,,c1S1-0
t NA-C.4 t
titit:;-re oTazgt-r-Teitt;:-Otr otner 0,oar or to,o'der of ro.00tgage, ,
GVa
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tor f
ily) '-----41:-.
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r:Dc 7 Tax'og D strict, 1 Has th.o,deduct Ion a d requested ,It yes se-amount O--`dagd-d-6:b-r
ca 7- ---- --'.
t- 7 1 onr--
current EDS !--_-_1 NO ,
A p dance on the persons mortgage or c ntr ct indebtedness that is recorded in the county
re c 4S- a07-5,01x) 0? - Drded in the county recorder's office that 's the basis for the deduction
COUNTY AUDITOR
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20 __.
20_ 20 : 20 i 20 20
20
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I I We certify under the penalty of perjur, h ,th- above and foregoing information is tr e nd correct and that the appfcant is reside t of Indiana and
owner/contract buyer of the aforementioned property on date application is filed
FF '-re_ e.ehe. -diseess of apsLicart(ramber e-rd street,e'}i _ii state boiiiii-g4iP c19__c 14 c,1717 -II ---
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Person t6rized by del;exegutert Power of Attgroey or b;IC 6-1 1-,2-0 7 Date.(rronti, day year,
•
Adi,ressd1---abt-crized parser (number ad stoeet city state. and Z/P ccd-d.
irri In ri,,,,,,t tin to lain and a half years and a fine not to exceed$/0 000