HomeMy WebLinkAboutMortgage_Nixon Year i
---4'05`-.-^,?--- STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS — Co—unty T ownship 1
!
%' FOR DEDUCTION FROM ASSESSED VALUATION . __
------t,-;
f 1 i S:ate Fora -,3709(R14/1-201 1 Gibson
-...,:z;-......___. :..i..• ;Prescribed by Department of Local
I ri7,
Must be filed or postmarked with the County Audam Count,:Auditor or County Recorder of the county where the property is I 2
located on or before January 5 or the Calendar yea.-in which the p-aped;taxes are first due and payable ; L____.! County Recorder
See reverse side for add,tione!instructions and qualifications
„._
Ap--77.z.a117cx ee-o-ctra.:-.!byyef--see res)f-if:t.c)-)s or re/arse s,:iaI
N C0-- K.,;)(can
i Z 2 1 Tfil --ii '4
f.lortaage.i CO7t-a7ti7d55:rdress,l-71.•-a d as o' I lsloOrgage i Cciaborr.irde,c•ed-ae.s uroard as-e"
a-esess-ert da..15 ccircril yea- assessmert date csrrert yea- I da1e or appiisaron 1 lega or equitable oi.i.,da-?
I • 73 5:ez7 ___..
L...._. es E No
___
tf ro v.rat is h 5!be'exec.,:sha-e o'trite-es? I If ca.osea vile someone othe-C-Ta-O spouse indioale si:th vir,C-r-7-1
• p70?- -i;•- iJ ' As-eessed
-fifear-ie en race-d is d fferert tea-fr at c"asp'dart i7:-.,' qeSt..7..7 Arnadily.IS the
i N-a-rri-5-d7O-r7o..rtoaeee or coet-art sre:se Drawer NO 02Q,2 / LiitiLfal Property ri Annua'lyuobieH Assessed
_ __. _
(81Cse6d-1.1-7)
cordrari se.F.1,"(r.,.:71,...,T.,a-7d.!
Card NO. 4/?—'7-77
_._
7NO:11r-Te C-1-aesi'gree o-erne-ov..re/o-he'd-a-c,"-r-s-ti,
FEB 1 6 2022
..-,E,i,.-.!-i,sso,.. 3",r,E.,(e iirriter--3)),f s),',.).,f cif,. se ad 7/P cod'-) —
,d 7
---,-,-,....-.-„,--„-,:c-.;....-..3--p-;:b-,,:,-,,r-ty ir a I I'yea.; vieal coorry, --.7--V.-1 3'.Tax-rig D sl-irITT 7 Has this dedaCiTO7 beer erifes-ad FiPft§9.4aPPAPI.......trOrArsignt-QR. 1 9the-cieur1i 1-,.....j yes ii.,..4<,-; , !on properly for ,..---.„2.<" ,T.-,-- I -
in leo ara, I current yearra t eS L i No i
i
ilf7;
A person is not entitled to this deduotion unle.,..ss the person has a ba'ance on the person's mortgage or contract indebtedness that is recorded in the county
recorder's office(including any home equity line of credit that is recorded in ti)e county recorder's office)that is the basis for the deduction
-------
COUNTY AUDITOR
(5:7d7,----a-r7p-O7. O. ,',ir--7-...;/r...O.:d-
20 i 20 20 20 20 20 .--i
s6O-rTilyirirt ' u Coi-rly 1 Da1e(a-orre dai yei.ff-f
, ,Vie cert.fy 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
owner/contract buyer of the aforementioned property on date apol cation is filed i
_______
Sc i-attrie(o.vre-i's r,',,,-,0; DE.,-:r-i--....,-i-i c./ey ye .-)
)1ate._ -.''R- ^k(
yr.__offn f J:),1 I 1G./-
i'T... 7,----•-...---...dor-r-r:s a.asolizar:(ricie-55--eed 5f,,,,'... C':',' V..,7/!••• E3-../ZIP..7-:::ie, —
1 '5,-,,,frfif, Li.5e-, en A- .r- p i ,,,..... .......,..-7 .,,..4.,.,_./1.4.,____,4-7 4,1 c). __._._
---.11e-sor a.:17-orize..5 by Coy ex-5.ruted Pose-c"Atrorre,or by Ir.t 6-1 1-12-C 7
Date forrietir day),,-.3af-7-
A t d,e s s 0`a,t,0,-Ze2 person (corrter area slreet cry sira1e. ard ZIP coce. -- i
The penalties for perjury can include imprisorment up to two and a halt yeas and a fine not to exceed S10.000