HomeMy WebLinkAboutMortgage_Knight^'� STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS Coun shi ear
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� FOR DEDUCTION FROM ASSESSED VALUATION
Stata Form 43709 (Ri 1/ 6-W)
�• I presaipetl py oepartment ot Local Govemment Fuance
�STRUCTIONS: ��� �
Fam Ned with:
To be fifed in person w by maif with fhe CounlyAuditor or Counry Recorder of the wunty where the piopeRy is located. �
Filirg Dates: 1J Real PmpeAy: Must �te dunrg fhe year for which the deducfion is sought C� " uditor
2) Mobde / Manufactured Homes rat assessed as Real Property: Must file during the fweNe (72) months j�j
be(aelAarch 37 o/each yearthe deduclion is swght. GIBS N C`��N7Y �
See reversa side 7or addrfbnal instructans and qualifications. �
I'
X
T _% — — Ol�. U%Q6 �%
p�,ed vafue proper;y as ot Mortgage/ Contract irMehtetlness unpaid as W Mortgage / Can
� 7, Ma�d� 1, wrtent yeer tlate of appGmt
If ra. what is his / her exar� shafe of interest'+ 1� w�'ned `�+M sameorre o
reme an
rtwrt�ag¢e or mnVaG seller
Name ol asignee w
ubicate Gebvr
mortgage
sfate. ard ZIP cade)
AECress of assi9nea (nurneer aro s++ee; rn}: s+aze. aim c�r cooe7
Does appli�nt am property in any oNu
munryinlntliana? ❑ YE5
r
Deduction appoved 6+ ihe amount ot
20 Z� _
Siu�alure of CAUnfV Auditor
; unpaid as d U �he appfiont Me sole
legal w eQUrtaWe o-nnelt
❑ Yes ❑ No
hdinte wiih whom
IS Mp praGertY in Question: MnuaAy Asse55eE
14ReaIProPerlY ❑AnnuallyAssessed
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f� (J �� �" . � WU
Q(�" ad`� �
COUNI
20 _ 20 _ 20�
Counry D
� � P�WU�Y
s ❑ No
�Y 1'��)
�
1/ We certify under the penalry ot perjury Nat lhe above arW foregoing information is We and cortec[ and that the applirant is a�resident of InEiana ard
owner I conVact buyer ot Ne atwementioned property on date appiiration is filed.
vutivn lowneA fu7 �amd� A � _ Date (�^�. dsY. Yea�)
and
, � d
Person aulho�rzetl Gy duty exewtetl Power o(Attorney m by IC 67.7-12-0.6 I Oate (monN,
Atldress of authomed person (num6e� aM streeL tlry, sta(e, aM ZIP code) .