HomeMy WebLinkAboutMortgage_Benkert A.c.,..-5 .4-,,--„,. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS ----county i Township I Year l
FOR DEDUCTION FROM ASSESSED VALUATION _
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4"iiltfi Sae1-.'.. te F0, 43709(R14/1-2-D) 1 Gibson I 00g i
---.....;--... •-• pre...,:cribed by Departmcent of LCC2i Government Finance
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File Mark
INSTRUCTIONS' To he fled in person or by mall.
Filing. Dote Form M.-is!!be compfe.ted and dated in the calendar year for which the deduction is sought
Must be filed or postmarked with the County Addclor or County Recorder of the county where the property is 1 RI County Auditor
located on or before.January 5 or the calendar year in v.'hich the property taxes are first die and peyebta, c' I
....,ounty Reco).(-J„.
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se reverse side to-aid/ionsl instructions end qualifications -_
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ty.•int,Dist-irtti.,.. i Ke,•r'"rbH."i lezai des:I.-opt:7,-o ------.-Rs-orct onrinbe- i Pa:1,,honet7e7- 7
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aSS.53SS—t-7 date.ccrTact ye.et 1 assessMerli dcte. ci_pirer.tye..-3- cistab‘aci,c- cation I less'otiect,,oitstSe-o•.;;;;-?
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I j_ .eal Property CI Annually Assessed i
It„lobile Home(IC 6-1.1-7)i
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o.h.e.!TF,':g D•stOct, !Fiss this deV..0h c.requested !V iee,,,O,..,±___ .---------i-&17..".:nton ---1
'ce prope.rty , 1 i
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CUHEarl:yea,? , Nes ri No
Drawer NO 4;20e) t2 ----- ---
as a balance on the person's mortgage or n radt indebtedness that is recorded in the county
'is recorded in the coohty recorder's office h is the basis for the deduction.
COUNTY AUDITOR
Card NO. 163‘-/ __________
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20 20, . --
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I r Vile certify under tine penalty of periiry that the above and foregoing information is o and correct and that the applicant s a r sident or Indiana and
0 ono. buyer of fi a aforementioned property on date appl cation is file,d
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Pe,-5c-1 a.lt,o,ze,t tv d..:',,,exect.ute.d Pc,.er ot Atitd-r-ei cr by-17.E-1 1-12-0 7 i Date(r.-.7 17 f r 6,,,,;...
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ACdrsss of s....;thcrizarl pers•Do (eurcr•-isT sod sttets.t or/ stets. and Zia cede —
The p=neltes for perjury ceo include imprisormertt up to two and a holt yeas and a fee not to exceed S10.000
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