HomeMy WebLinkAboutMortgage_Snyder (3)� STATEMENT OF MORTGAGE OR CONTRACTINDEBTEDNESS
FOR DEDUCTION FROM ASSESSED VALUATION Coun Township Year
S M� / Stata Fwm 43709 (RS / 4O3)
� PrescriEetl Dy Department of Local Govemmeni Finance
INSTRUCTIONS: S E P 2 R�i e 3�
To be filed in person or by mail with the County Auditor o! the county where the propeRy is located.
Filing Dates: 1) Real Property: During the 12 months be(ore May 11 0l the year the deduction is to effective.
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0( th t 9' ' ctive.
See reverse side (or addilional instnictions and qualifications. GIBSON COU TY AUDITOP.
Appticant (ownerorcontract buyer-�see restricti s on reverse side) �
Ta ng Distrid Key number / legal descrip n ' Record number
880
�L�,�, D� �/ - �G � _ � Page number
A essed value of real property as of Mortgage / Contract indebtedness unpaid as of Is the applicant the� �s le legal or equitable
March 1, wrrent year March 1, current year ownef? ❑a'es ❑ No
/U V (�J�
If no, what is his / her exact share of interest? If owned with someone other than spouse, indicate with whom.
If name on record is diff �^� �hat of applicant, indicate betow: Is the property in question:
�ra � ❑ Real Property ❑ Mobile Home pC Cr1.1-�
�ame of mortgagee o Wer �'0.,,. , �
�
Address of mortgag� card �'�• .. O 3.. •�"�� ,te, ZIP
. p
Name of assignee �
Address of assignee (numberand street, city, sfare, �..
Does applicant own property in any other If yes, what wunty? What Taxing District? Has this deduction been requested on
county in Indiana? property for wrrent yearl � Yes❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 � 20 �� 20 �� 20
� ` /"
Signature County Auditor Date `
�I! We certify under the penalty of perjury lhal lhe above and foregoing information is lrue and corred and thai the applicants was / were
3 residenl of Indiana and owner of the aforementioned propeRy on March 1, 20
Signature (ov;aers full name) Person authorized by duly executed Power of Attomey
.�.� ,,, ,�,�„ — or by IC 6-1.1-12-.07
�
Full resident address of app nt Address of authorized person
� 34 z, ��� .�
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